Preamble

The House met at half-past Nine o'clock

PRAYERS

[MADAM SPEAKER in the Chair]

Firework Safety

Motion made, and Question proposed, That this House do now adjourn.— [Mr. Bates.]

Mr. Richard Burden: I am grateful for the opportunity to raise this issue. It is only two weeks since the headlines were full of news about firework-related tragedies. On 28 October, a 10-year-old boy, Dale Mitchell from Nottingham, died through the illegal misuse of fireworks. On 1 November, David Hattersley, a head teacher from High Wycombe, was fatally injured during his school's firework display. On 2 November, Stephen Timcke, a City trader from Kent, was killed in front of his two young sons, aged five and seven, at a private bonfire party.
The headlines may have gone, but the consequences of those tragedies live on for the families and friends of those who died, as they do for all those injured by fireworks. That is why the House is under an obligation not to wait for the next tragedy and the next headline, whether it comes next month or next year at bonfire night, but to take action now to improve firework safety.
I secured an Adjournment debate on the same subject in November last year, when I raised questions about the sale of fireworks to the under-16s and the importing of dangerous fireworks. The sale of fireworks to the under-16s is still an issue. In 1995, 825 of the 1,500 firework-related injuries affected the under-16s. We still need to take more effective action to ensure that children are not able to buy fireworks and that a responsible adult is in charge wherever fireworks are used. The Government's zeal for deregulation has not helped us to achieve that, but that is not the issue that I want to spend time on today.
I want to consider firework imports in depth. Last year, I told the House that shipments of Chinese fireworks containing illegal substances had been allowed on to the market in the United Kingdom. Only in October this year, more than a year after authorisation was first given for those fireworks, were the last container loads tracked down. They had been on the market in this country throughout that time.
The Government had unnecessarily scrapped import licences for fireworks in 1993. The Health and Safety Executive's actions in authorising firework imports at the time of last year's debate left a good deal to be desired. Since that debate, its performance in scrutinising import applications has improved considerably, but the procedures are not in place to check that the products for which importers apply and receive authorisation are the

same as the products that come into the country and find their way on to the market, and to ensure that those products are properly labelled.
Example after example can be quoted. There was a raid only yesterday—as prosecution is pending, it would be inappropriate to say where it happened—involving a 40 ft container of fireworks that had found its way into a lock-up garage in this country. We must wait to see how that prosecution turns out, but we must ask why nobody knew that that container had come into the country and why it was checked on only once it had found its way to the lock-up garage. Why did we not know? Why did the authorities not know in advance?
Perhaps an even more tragic example is that of Stephen Timcke. He was killed by a mortar shell, which was probably not meant to be on general sale in this country. It was imported from China and all the instructions were in Chinese. He died at a private bonfire party, in front of his two sons. All sorts of questions are raised. Who sold Mr. Timcke the firework? How did the vendor get hold of it? How did it get into the country and—perhaps even more chilling�žhow many of those fireworks are still in circulation and in the shops to this day?
Investigations are continuing and it is right that they should, but it is on that matter that I seek my first assurance from the Minister for Competition and Consumer Affairs and the Under-Secretary of State for the Environment, the hon. Member for Croydon, Central (Sir P. Beresford). Will he and his hon. Friend assure me that the Health and Safety Executive will not grant authorisation unless arrangements are in place to ensure that each consignment of imported fireworks is logged at the port of entry, transported directly from the port—sealed—to secure storage at a recognised site and routinely tested before it goes on the market? Unless that is done, authorisation is fine, but there is no way of checking whether what has been authorised is what finds its way into this country and on to the market. The results are tragic and only too plainly seen in the death of Stephen Timcke. It is within the Minister's power to do something about that and I ask for that assurance.
Secondly, on categorisation of the different sorts of fireworks, the Minister began a review of firework safety regulations in March and I welcome his initiative, which was useful. When he takes into account the responses to that review, I hope that he will consider removing bangers from general sale. I met him a couple of weeks ago to discuss that. With 316 injuries last year alone, more accidents involve bangers than any other type of firework. They are easy to abuse, have no visual appeal, are a nuisance to people and frighten animals. They should be taken off the market. I strongly urge the Minister to agree that course when he considers the results of the review.
Some measures cannot wait until the review is completed and the results known. Stephen Timcke was killed by a mortar shell, as was David Hattersley, the head teacher from High Wycombe. The signs are that Mr. Hattersley acquired the shell lawfully. It was probably a category 3 firework, for use in large outdoor spaces. Mortar shells are freely on sale. What are they? I can reassure you, Madam Speaker, that the one I have here is a dummy and there is no danger to the House. It is a dummy of a 4 in mortar shell. It looks like a lethal weapon and we know that, in the cases of Stephen Timcke and David Hattersley, that is precisely what it was.
Mr. Hattersley suffered the most appalling facial injuries when the mortar shell exploded in his face—injuries from which he died without regaining consciousness the following day. Such a firework has no place on general sale in this country. It has no place on sale now—we cannot wait until after the review, until next year, or next bonfire night. I do not want to see any more tragedies such as were suffered by Stephen Timcke or David Hattersley, and they were not the first, as someone in Yorkshire was killed by a mortar shell two years ago.
Under the Consumer Protection Act 1987, the Secretary of State has the power to ban by order, for a maximum of 12 months, the supply of anything that is considered unsafe to the general public. He does not have to wait for consultation or for the review. I imagine that 12 months will be long enough for the Minister to complete his review and to consider all the other matters, and long enough for changes to be introduced—either by this Government or by the next Labour Government. Will the Minister assure me that he will not allow lethal items of equipment such as mortar shells to remain on general sale, so that we can be confident that there will be no more accidents, no more Stephen Timckes and no more David Hattersleys, while the review is taking place? The public demand action, and I hope that the Minister will assure me that he will take the action that it is in his power to take, to remove such shells from public sale.
Thirdly, we should consider training, in particular the training of those who use powerful category 3 fireworks, such as the one that I have here, which are on sale to the general public but which should not be, or category 4 fireworks—the category that I should like such fireworks to be put into. Those are fireworks that are not meant to be on general sale to the public, but which are meant for use in displays. According to British standards, category 4 fireworks are not meant to be on sale to the general public, but no clear regulations are in place to specify who is allowed to buy or use them. There are no real restrictions on their purchase or operation. As a result, someone without any formal training can buy and use category 4 fireworks, setting him or herself up to run a public display. Surely that has to end.
My third request to the Minister—again, it is entirely within his power to agree—is that he should establish straight away a national training scheme for those running firework displays and using category 4 fireworks. Will he ensure that no one can run such a display without appropriate and recognised training? For that measure to be effective, we need to control the places through which category 4 fireworks are distributed. Will the Minister ensure that they are on sale only from licensed premises, so that we can see where they come in, where they are stored, who is entitled to sell them, to whom they are sold and who is allowed to operate them?
The Minister might say that that is complicated and difficult to do, but it is not. A model for exactly the sort of scheme that I am describing exists in Canada. Support for such a mandatory scheme comes from a wide range of organisations: trading standards officers and departments have voiced their support, as has the Royal Society for the Prevention of Accidents, the Consumers Association and the National Campaign for Firework Safety, to name but a few. Responsible members of the fireworks industry have also voiced their support for such a scheme, because

they know that it is not in their interests for public safety to be put at risk and for people, who frankly do not have the skills, to buy and use powerful category 4 fireworks. That situation reflects badly on the industry, and responsible members of the industry want it to end.
The Fire Service College has said that it has the skills and is willing to run a training scheme. It only remains for the Minister to give the go-ahead. Will he introduce a requirement for such training and for the licensing of retailers of category 4 fireworks, so that we can be sure that items of equipment such as the mortar shell that I am holding are not used by unskilled or untrained people?
I met the Minister the week before bonfire night, to discuss the Department of Trade and Industry's firework safety publicity campaign, to raise again some of the matters that I raised in my Adjournment debate last November, and to consider the review that he is undertaking and some of the issues arising from it. He received me with the utmost courtesy, as he always does, and I believe that he has the best intentions on firework safety, but we need more than good intentions and reviews: we need action to back those up and prevent further tragedies.
First, will the Minister and the Under—Secretary of State for the Environment, who is also involved through the Health and Safety Executive, tighten controls on the importation of dangerous fireworks? That can be done only by checking at the port of entry, transporting the fireworks directly to secure storage and routinely testing them before they reach the market.
Secondly, will the Minister put a temporary prohibition order on sale to the public of mortar shells and similar powerful fireworks that, by any standard, should be in category 4, while the review is undertaken, so that we can be sure that the public are safe in the meantime?
Thirdly, will the Minister establish a national training scheme for anyone who wants to run displays and operate category 4 fireworks, and ensure that those more powerful fireworks are available only through licensed premises? If he is prepared to do that, I am sure that he will have the support of all Opposition Members.
For goodness' sake, let us not wait until the next bonfire night, witness more tragedy and injuries, and ask ourselves why we did not act when we had the chance. Let the memory of David Hattersley and Stephen Timcke be our spur to taking the actions that are necessary to ensure that the public are able to enjoy fireworks in safety and that we avoid any more tragedies of the kind that we have witnessed this year.

Mr. Chris Davies: I congratulate the hon. Member for Birmingham, Northfield (Mr. Burden) on securing this debate. To my knowledge, this is the second time that he has initiated a debate on the subject. The previous one was on 1 November 1995, and perhaps it is appropriate that this one takes place after 5 November, because there may be a tendency for views to be heightened and emotional when constituents are expressing concern in the run-up to bonfire night and for the emotion to fade away in the aftermath. So we are more able to consider matters rationally and seriously in the cold light of late November.
The time is appropriate also because the Government's consultation paper is still on the stocks. The closing date for submissions was 16 October, but I hope that the Department of Trade and Industry will take into account the points made in this debate. I welcome the review.
Like the majority of people in Britain, I enjoy fireworks. I have taken part in displays in a family environment since my earliest years and I would not want to deny such pleasures to others. Fireworks are extremely popular in Saddleworth in my constituency, and the Round Table and other local groups take every opportunity to organise displays of a high standard. I hope that my constituents and I will continue to share that pleasure.
My first concern is about the period during which fireworks should be on general sale. The guidelines agreed some years ago say that fireworks should be on sale for only three weeks before 5 November and a few days after. My impression is that those guidelines are becoming loose and that fireworks are on sale earlier than they should be.
This year, fireworks day seemed to go on for a long time, perhaps because 5 November fell mid-week and people increasingly prefer to have family parties on weekends rather than on the due date, and because the weather on 5 November was not pleasant in many parts of the country. I received calls the following week saying, "When is this going to stop? I can't let the cat and dog out because every time it gets dark there are fireworks going off all over the place." The matter needs to be reviewed.
People increasingly use fireworks on occasions other than bonfire night—to celebrate anniversaries or birthdays, for example. We must consider what special provisions should be made to ensure that fireworks are available to those who want them for legitimate purposes, but not so freely available as to extend to the whole year the period during which annoyance is caused to ordinary individuals.
The hon. Member for Northfield referred briefly to bangers. Three weeks or so before 5 November this year, I received a call from the estate management board of Holts village in Oldham, expressing concern about the number of bangers being thrown around the streets and put through letter boxes by youths, causing anguish to elderly people and others. I had another call from someone who had seen youths throwing bangers out of the back window of a double-decker bus.
There exists in legislation a maximum penalty of £5,000 for throwing a firework in a street or public place, but I have never yet heard of its being implemented by a court. The small banger is increasingly being treated disdainfully and used by youths as if it were a home firework. Perhaps that is reflected in the fact that more than 50 per cent. of all accidents with fireworks involve children under the age of 16.
I raised the matter with the managing director of Standard Fireworks and Brocks International last year. In his reply, he said:
I well understand the problems caused to the general public and in particular the elderly through the misuse of bangers and other noisy fireworks.'
In a revealing and honest statement, which is unlikely to boost his marketing effort, he said:
The Standard Fireworks banger is the most ineffective banger on sale in the UK today. Our sales have continuously been falling, from a high of 7 million to 2.5 million last year.

I acknowledge the fact that Standard Fireworks has been closely involved with the Government in reviewing guidelines and codes of conduct, and I approve of the attitude that lies behind what the managing director said—his letter went on to express his concern about the importation of much more powerful bangers—but the simple, cheap single banger is increasingly being used as a weapon and as a means of disturbing and frightening people in many estates and communities throughout the country. It is perhaps time, as with ripraps, crackerjacks, squibs or whatever, to introduce a complete ban on the sale of bangers.
Most accidents involving fireworks affect young people aged under 16. How do they get hold of such fireworks? It is illegal for fireworks to be sold to people under 16. When the matter was raised in the 1 November debate last year, the hon. Member for Northfield—I remember that I was unable to make an intervention—mentioned that trading standards officers were concerned about how regulations had been changed, because that had made it more difficult for them to enforce the law. The Government said that the existing regulations and laws gave trading standards officers the authority to enforce the rules. However, in practice, trading standards officers still find it difficult. They admit that it is possible to carry out enforcement, but it is more cumbersome, bureaucratic and time consuming and they have other things to do with their limited resources than concentrate on that one problem.
In trying to reduce bureaucracy for small businesses by scrapping the regulations concerned, the Government threw out the baby with the bathwater. Governments are never willing to accept that mistakes have been made, but I hope that in this case they will recognise the due concerns of trading standards officers. I spoke to trading standards officers in Oldham and Rochdale only an hour ago and they said that, against their will, they had made no effort to prevent the sale of fireworks by shops to children under 16, but had referred the matter to the police. They did that because they believe that the regulations are too cumbersome and need revision. I ask the Minister to ensure that he takes the opportunity of the consultation to listen to their concerns and review the regulations. I hope that by this time next year, more simplicity will have been introduced into procedures.
The point of the hon. Member for Northfield that mortar shells are classified as class 3 fireworks was well made. Mortar bombs and the like have instructions that state that they should be used at least 25 m from the public and are clearly inappropriate for most domestic gardens. They should be reclassified as class 4 fireworks.
There is also the increasing use of fireworks to celebrate new year's eve. I go out of my house at midnight on that night and from all the hills around me I can hear fireworks going off and see lights in the sky. The crucial problem with the use of fireworks on that day, which makes it different from bonfire night, is that on 5 November, most fireworks are let off between 6 pm and 8 pm; those on new year's eve are let off at midnight. It is likely that people who let fireworks off on bonfire night will be sober, but on new year's eve, they are likely to be intoxicated. If I had a simple answer, I would give it, but I ask the Minister to take that point into consideration in the consultation paper. I hope that he finds a means of tackling the problem and reducing the likelihood of accidents.

Mr. Barry Sheerman: I congratulate my hon. Friend the Member for Birmingham, Northfield (Mr. Burden) on introducing the debate so meticulously. He has been through the detail, and I shall not bore the House by repeating his sensible suggestions. I shall merely reinforce his points and hope that the Minister comes back quickly and strongly on everything that he said.
I must declare an interest as the Member for Huddersfield. Not in my constituency, but nearby in Colne Valley is Standard Fireworks, the largest producer of fireworks left in Britain. It is an excellent company that employees several hundred people and is renowned in the House and outside for its interest in safety and its good-quality fireworks. I congratulate the company, the last of the big fireworks companies in Britain, on maintaining high standards of production and of regulation of its activities and on its tremendous work in putting its own money into safety and in trying to ensure that people can enjoy a traditional holiday. One does not need a day off to have a holiday. Bonfire night is a holiday tradition that goes back to 1605. I do not know when fireworks were first let off, but it was long ago. It is deep in our tradition.
I resent the killjoy tendency in Britain whereby when there is a crisis or accident, there is an emotional spasm that says that everything must stop. I share the deep feeling of sympathy of my hon. Friend the Member for Northfield for the people who died recently as a result of fireworks, and for their families. I feel strongly about the way in which their deaths were caused. However, we have to balance that with the fact that fireworks are a traditional way of celebrating 5 November, Guy Fawkes' day or plot night, as we call it in the north. I do not think that it should be stopped. Fireworks can be safe if they are good fireworks, properly regulated and let off sensibly.
There are, of course, dangers. If people who are not adult or experienced enough let off fireworks, there can be tragic consequences. But they can be overcome. The hon. Member for Littleborough and Saddleworth (Mr. Davies) mentioned the honesty of the chairman and managing director of Standard Fireworks about his bangers. He has been equally frank with me. It is a part of his market, but I am sure that he shares my view that if there were no banger market, Standard could cope with it. Most of us know that the real enjoyment of 5 November and of fireworks is the colour and beauty of a firework display. My view is heartfelt because I have an interest and because I know that there is a tradition that is precious to many millions of people. I want that to continue.
I am going to say some hard political words. The Conservative party is the great party of deregulation. Since I have been in the House, it has shouted it from the rooftops. The high priests of deregulation, whether Front Bench or Back Bench, cannot wait to tell us that the state should not get involved in anything. They want total deregulation. Let the buyer beware, let people buy anything they like and let off anything they like. Fireworks are a classic example of what happens when that ruthless attitude to deregulation comes home.
The Minister will not like me saying that two people died this firework weekend because of deregulation. They died partly because of the deregulatory attitude of the Government, who have weakened controls against the

best advice of the industry in Britain and of senior staff at Standard Fireworks. They said that we should not deregulate and that if we did, we would get all sorts of dangerous rubbish from China and elsewhere and accidents would occur. That was self-interested, because if accidents happen, people say that fireworks should not be let off at all and that we should end fireworks. I have been involved in the matter for some years. I have heard the industry and my hon. Friend the Member for Northfield say that deregulation will spoil it for everyone. Yes, it will; deregulation has spoilt the lives of families whose loved ones have either died or been dreadfully injured by fireworks that have come in from abroad.
The incident was not isolated. I went to my village and someone in a shop showed me a firework costing £60, which was about the size of a birthday cake. It was not for a special occasion or display, but for anyone to buy. Trading standards officers do not have the power, effectiveness or will that they used to have. A parallel can be drawn with the sale of alcohol: a survey of who could buy alcohol in my area was conducted in recent weeks. The police sent a nice letter to all off-licences asking them to stop selling alcohol to young people. The police said that it should be done the easy way, and that there was no need to be heavy—the young purchasers should be identified and the sales stopped. But the campaign did not seem to be effective.
The police sent 14-year-old boys into off-licences: 20 out of 31 served those boys with alcohol—in two cases, they were served by a 13-year-old and a 12-year-old. As I went round my area before 5 November, I found that precisely the same happens with fireworks: very young children get hold of them and the deregulatory climate seems to be responsible.
The situation is bad enough, with deregulation and the people who have been injured or killed as a result. But, worse, two years ago there was a death in the constituency of my hon. Friend the Member for Wakefield (Mr. Hinchliffe)—he will speak in more detail about that. The coroner spoke directly to the Minister involved and said that such evil fireworks should not be brought in. For two years, the Government have done nothing about those fireworks, which have come into this country and killed people.
I have spoken strongly about the subject. I do not want to be a killjoy; I want our lovely festival to continue; I want proper curbs. I have no special mandate for bangers, which are misused, and I have no special case to make for the extension of the time for using fireworks. The traditional period in our country is quite short—about three weeks—and I see nothing wrong with that period being strictly enforced in terms of the sale of fireworks, apart from their use in displays.
Some of us who were holding meetings in the House of Commons on 5 November almost thought that we were under attack. I had booked a Room overlooking the river, and there was a fantastic firework display on the launch just outside the House of Lords. It was a magnificent, safe and enjoyable event, which showed how fireworks can be used.
If the Government continue their deregulatory, care-for-no-one attitude, more people will die. If the Minister does not take action before next year, other people will die. But by then there will be a Labour Government who will ensure that firework displays are safe.

Mr. Bill Michie: I congratulate my hon. Friend the Member for Birmingham, Northfield (Mr. Burden) on giving us the opportunity to debate this important issue.
I want to start my speech where my hon. Friend the Member for Huddersfield (Mr. Sheerman) left off. We are not here as killjoys to try to stop people enjoying themselves or to try to stop various organisations and religious bodies celebrating holy days—that is nonsense. The Firework Safety Bill and the debate are about the effect that fireworks can have on ordinary citizens who have no argument with people enjoying themselves, but are merely asking for some consideration. Animal owners also need consideration, but I shall come to that subject later. This is a debate not about how to stop people enjoying themselves, but about how we can find a way of ensuring that people can still celebrate while protecting those who are greatly affected by fireworks.
No one doubts the fact that fireworks give pleasure. I thoroughly enjoy attending the displays at my local park. It is worth congratulating local authorities and other organisations that put on tremendous displays, in safety, and that often educate children on the dangers of fireworks, how to place them safely and how to stand away. People should be congratulated on holding firework displays and educating others.
Safety is a priority, particularly for organised bonfires. As my hon. Friends have already said, how can it be safe for someone to let off a £20 or £60 shell in their back garden if he is meant to stand 25 yd away from the firework? Many back gardens are not 25 yd long, so people would have to stay in the house—the firework would no doubt blow all the windows out. One firework, which must have misfired, came over my fence and exploded above the lawn. I was amazed that none of my windows were blown in. All the fire alarms, burglar alarms and car alarms went crazy. Who knows what would have happened if anyone had been within a couple of yards of that firework—admittedly, it misfired. Some fireworks have a shell casing, which is almost like shrapnel when they explode. We need to regulate such fireworks, some of which are powerful.
Most people enjoy the visual aspect of firework displays, which are fine if they are beautiful spectacles with a few crackles, but I see nothing visually beautiful about one big thud that frightens half the population to death and is then over. There is a difference between the two types of firework displays. I have doubts about how we can regulate the use of most fireworks. By banning bangers, we have gone a long way to answer most of the complaints raised in our surgeries.
I received a typical letter from an old lady in my constituency. She wrote:
Dear Mr. Michie,
I sit in my home this evening, and feel as if I have been living in a war torn area for well over a month now".
She goes on to describe the loud explosions and the difficulties that she faces. She mentions the advice given by Rolf Harris on his programme when he told people to ensure that they kept their animals in on bonfire night as it was likely to be distressing for them. Keeping a dog or a cat inside for one or two nights is one thing, but how can someone keep a pet in for about two months, which seems to be the period in Sheffield?
At the end of her letter, the old lady makes a plea. She asks:
Yes, people have rights and some things are difficult to enforce, but could you please help us, speak up for us, the fed up majority, and quieten the minority that disturb the peace over a sickeningly long period of time?
The letter finishes, "Help". I know that, like that old lady, some live in blocks with other old people, and I have talked to them. They are terrified at the sheer noise, which affects them psychologically.
I do not know whether we can restrict the time for selling. As my constituent said, that may be difficult because we have to consider religious groups that celebrate at different times of the year. It may be difficult to restrict the time during which fireworks can be usedk—it might be a good idea if they are not used after midnightk—but it would not be too difficult to control the sale of fireworks. That would not stop people hoarding them and setting them off at the wrong time, but it would stop what is happening in a shop not far from where I live. It is open many hours a day, including Sundays, and sells nothing but fireworks for months on end. It encourages people to make impulse buys. If a child walks past the shop and realises that he has enough spending money to buy some fireworks, he will go in and purchase them. Restricting the times and dates on which fireworks can be sold may help to ease the problem.
As I said earlier, taking bangers out of the equation is certainly the most effective way of helping the majority of people. Old people and animals live in fear. Unfortunately, I no longer have a dogk—mine died of old age many years ago. It was a sheep dog of a nervous disposition, to say the least, and for bonfire night and perhaps the night after, I used to get a tranquilliser for him from the vet. It did not actually knock him out but, for some unknown reason, he used to walk about as though he had gone deaf, so it obviously worked. The problem is, however, that it is not possible to keep giving animals tranquillisers for two months or more, just because some great firework might go off. There are therefore limits to what animal lovers can do to protect their animals, just as there are limits to what old people can do to protect their nerves.
The onus remains on the House to find some way of restricting bangers or, hopefully, banning them altogether. We must take action on behalf of those who do not want to kill the joys and pleasures of others, but who want only a little peace and quiet. That way all of us, not just a minority, can have a happy life.

Mr. David Hinchliffe: I am grateful for the opportunity to raise my concerns relating to the circumstances surrounding the death in November 1994 of my constituent, Mr. Roger Robinson. His case has already been mentioned by my hon. Friends the Members for Birmingham, Northfield (Mr. Burden) and for Huddersfield (Mr. Sheerman).
In November 1994, Mr. Robinson organised a display for elderly people at a care home in my constituency. He was killed as the result of the explosion of an


aerial shell, which was exactly of the sort described by my hon. Friend the Member for Northfield. The inquest report indicates that
The firework involved was 4 inch in diameter and is launched out of a mortar tube.
The evidence given at the inquest stated that
the shell had a weight of almost 15 ounces, was intended to reach a height of 800 feet before ejecting its pyrotechnic effects, and would have been travelling at a speed of 225 mph when it came out of the top of the tube"—
and hit my constituent in the face.
The Minister is aware that I have been in correspondence with him, his Department and his predecessor about the circumstances of Mr. Robinson's death. I was especially concerned to learn from the Minister's predecessor—the hon. Member for Brecon and Radnor (Mr. Evans)—who wrote to me on 11 August 1995, that import controls on fireworks exercised by the Health and Safety Executive had been abolished from 1 December 1993.
The Minister is well aware of the implications of that Government decision, which was presumably taken as part of the deregulation exercise mentioned by my hon. Friend the Member for Huddersfield. The Minister will also be aware that there have been extensive representations from trading standards officers in various parts of the country, not least in West Yorkshire. Here, I commend the West Yorkshire trading standards officers; we are fortunate in our area to have some of the most effective and articulate officers in the country. They wrote to the Government stating that those aerial shells were unsuitable for the public and should be banned from public sale.
The Minister will be aware that the inquest into the death of Mr. Robinson was resumed on 30 November 1995. The coroner for my area is my namesake, Mr. David Hinchliff. At the end of the inquest, he made a specific statement, which I shall quote briefly. He stated to the court that
pursuant to Rule 43 of the Coroners Rules,
he intended
to draw the attention of this fatality to the appropriate authorities, which in this case will be the Department of Trade and Industry.
Mr. Hinchliff added that he was acting
in the hope that a fatality or fatalities of this nature can in the future be avoided, that is the very least that I feel that I can do in this situation".
I have a copy of the detailed letter that he subsequently sent to the Minister on 3 January 1996. The letter makes his feelings clear. It states:
My recommendation must therefore be that Aerial Shells of all sizes should not be available to the general public, and that they should be sold only to people who have undergone appropriate theoretical and practical training.
I have a copy of the Minister's acknowledgment of that letter.
I know the Minister reasonably well and have always found him to be a decent and honourable man who is competent in his work. He always receives me well when we meet. However, I have to ask what has been going on—Mr. Robinson's death occurred in 1994 and the circumstances have been reported to his Department on

more than one occasion. Needless deaths have occurred that might have been avoided. I do not want to make a political point—the issue is too serious for that—but deregulation appears to have overtaken common sense and the sad consequences are there for all to see.
I want to repeat the point made by other hon. Members, particularly by my hon. Friend the Member for Huddersfield. I know of Standard Fireworks and I and my family have used its products over many years. It is a company of repute and I want to endorse the comments made by hon. Members to the effect that the industry wants not deregulation, but more regulation. Yesterday, I met Mr. John Woodhead of Standard Fireworks, who spoke in detail of his concerns about the implications for the industry of the sort of incident that I have described. Clearly, such incidents are not in the industry's interests and Mr. Woodhead wants more regulation, especially import controls—precisely the opposite of the Government's action in 1993. He wants there to be training along the lines described by several hon. Members this morning. Judging by our conversation, I am fairly certain that Mr. Woodhead would have no objection to bangers being banned altogether.
I have received representations from constituents similar to those mentioned by my hon. Friend the Member for Sheffield, Heeley (Mr. Michie) and the hon. Member for Littleborough and Saddleworth (Mr. Davies). People have had their lives made a misery in the period around bonfire night and they ask me why we have to have bangers. Would not having bangers really cause great difficulties? Would it really impact on the joy of bonfire night?
I am not a killjoy—in my childhood, bonfire night was one of the highlights of the year. In my area, we started preparing in August—chumping, we called it, which meant getting the wood in for the bonfire. It was a great event and I want that to continue. I do not see why we need to suffer the nuisance arising from bangers. I vividly remember the consequences for the guide dog belonging to my hon. Friend the Member for Sheffield, Brightside (Mr. Blunkett). As the direct result of being frightened by a firework, the dog was run over and had to stop working for my hon. Friend, who had to get another guide dog.

The Minister for Competition and Consumer Affairs (Mr. John M. Taylor): Comparing notes with the hon. Gentleman on our respective childhoods, I always found the bonfire more fun than the fireworks. I should like to thank him for his kind personal remarks about me and engage him not on the subject of guide dogs but on an earlier point. He referred twice to the fact that the import licensing regime was overturned in 1993. For the record, I want to make it clear that that regime was, in fact, replaced in 1993. The Health and Safety Executive will say that the single authorisation scheme that was put in place of the import licensing regime in no way weakens safety controls. One regime was replaced by another, not simply removed.

Mr. Hinchliffe: All I would say to the Minister is that I examined the issue in some detail and discussed it with representatives of the industry, whose impression is that the import controls weakened the safety aspect in this country.

Mr. Burden: The Minister is wrong—import licences were removed. The Health and Safety Executive provides


authorisation and classification on applications to bring fireworks into the country. There is no regular check at the port of entry and no way of telling whether the fireworks entering the country are the same as those for which authorisation was requested. There was no replacement—import controls have gone and they need to be brought back.

Mr. Hinchliffe: My hon. Friend makes an important point. That reflects my understanding of the industry's impression of the current position.
I conclude by congratulating my hon. Friend on initiating the debate. Without making party points, I hope that we can learn from the deaths that have occurred and that action will be taken. The action that we should take is clearly set out in the coroner's letter in respect of my constituent's unfortunate death.

Mr. John Heppell: I shall speak briefly because I missed the start of the debate. I apologise for that; I had to attend a meeting.
Today's debate is predominantly about import controls and about category 3 and category 4 fireworks, but I am worried about very small fireworks—those in category 2, possibly even category 1. I have been involved in previous firework campaigns, but I became involved in this year's campaign after being visited by a woman whose dog had been killed in a firework-related incident. I promised that I would support her in getting a petition together. Within days, a young man had died in my constituency because of a firework—apparently, not a big firework.
I urge the Minister to extend the scope of his review to smaller fireworks. Import controls would not have helped to save Dale Mitchell's life. I want something that would have done so—an increase in the age at which people can buy fireworks to 18. I want a licensing system. I want proper training in all categories of fireworks.
I shall present that petition to the Minister, probably at the end of this month—i hope before he announces the results of his review. He expressed his sympathy following Dale's death. I thank him for that, and hope that he will consider the petitioners' views.

Mr. Nigel Griffiths: This has been a debate of high calibre, probably because the only contributors have been Opposition Members of Parliament. The debate is the culmination of a campaign by Labour in Parliament, which has sought for five years to restore controls on dangerous fireworks.
My hon. Friend the Member for Birmingham, Northfield (Mr. Burden) has been at the forefront of that campaign, but others have supported him for many years—my hon. Friends the Members for Huddersfield (Mr. Sheerman), for Wakefield (Mr. Hinchliffe) and for Sheffield, Heeley (Mr. Michie). I welcome the comments of the hon. Member for Littleborough and Saddleworth (Mr. Davies).
It is important to examine the Government's record in action. Indeed, if it had only been in action, we might not be talking about the deaths today. From the questions that I tabled in 1989 to the hon. Member for Mid-Worcestershire (Mr. Forth) to my private Member's

Bill to restrict the sale of dangerous fireworks in 1994, and in Labour's calls in November 1995 and June 1996 for the banning of aerial shell fireworks, we have been outspoken in the cause of firework safety. In contrast, today, not one Conservative Back Bencher has been present to listen to us or the Minister, let alone to speak.
It was a Labour Government who, in 1975, secured strict controls on the type and power of fireworks, limited who had access to them and imposed a code of practice to regulate firework safety. Labour slashed the power of bangers and ensured that unpredictable jumping fireworks were abolished; both had high accident rates. As a result, for more than a decade, injuries plummeted to an historic low. For years, far fewer people suffered firework injuries and no one lost their life.
All that was changed when the new Tory right took over and decided to deregulate fireworks legislation. It destroyed the essential protection enjoyed by the public. The Tory ideologues covered three areas of public safety—the Department of Trade and Industry, the Department of Health, and health and safety. They are guilty of scrapping legislation that was the culmination of 100 years of firework safety controls.
In 1988, the Tory ideologues weakened the system of importation controls. Until that time, from 1875, the importation of fireworks was controlled by the Explosives Act 1875 Order in Council 10A. In 1988, Conservative Ministers repealed the tough mandatory checks on each type of imported firework by the Health and Safety Executive and replaced them with another system—self verification. Fortunately, importers still had to comply with strict safety rules.
In 1991, firework injuries had been cut to 723—too many, but far fewer than in countries with lax controls. The reduction in injuries did not last long. When at the DTI, the right hon. Member for St. Albans (Mr. Lilley), the hon. Members for Tatton (Mr. Hamilton) and for Gainsborough and Horncastle (Mr. Leigh) and the right hon. Member for Wokingham (Mr. Redwood) all ignored warnings from the industry and from safety experts.
In 1992, the chief inspector of explosives, Mr. G. Williamson, wrote to inform the DTI that some suppliers were selling category 4 fireworks to the general public. In a prophetic sentence, he warned:
The chance of a major incident clearly increases"—
but the then Minister, the right hon. Member for Stirling (Mr. Forsyth), did nothing.
In 1991, the United Kingdom firework industry lobbied the DTI for mandatory legal sanctions on the sale of dangerous fireworks. On 21 August 1990, in a letter to the DTI, our leading company, Standard Brock, said:
There is such a huge performance gap in the present Category 3 range as to confuse the public entirely and to put proper safety in jeopardy … I would move
aerial shells
into Category 4".
Still nothing was done.
The Minister will doubtless tell us that he has a consultation exercise in hand. Sadly, it will be the third consultation exercise that the Government have launched in the 1990s, as they have sought to push responsibility for firework safety on to Europe, the enforcement agencies, the fire service, the police and the trading standards service—everyone but themselves.
The Government conducted a consultation exercise in June 1993, and another in December 1994. They received a robust response from the Association of Chief Police Officers which, on 27 January 1995, wrote to the DTI, saying:
Under the Fireworks (Safety) Regulations it is necessary to prove only the offer to supply or the agreement to supply fireworks whereas the Explosive Act 1875 requires proof of the sale which can on occasion be more difficult to prove.
Both
police
forces feel that it is inappropriate to repeal this legislation and would seek to retain it".
In spite of that advice—that the Fireworks (Safety) Regulations were performing a valuable service protecting the public—Ministers went ahead and abolished them. The assurances that the Minister gave us earlier—that that made no difference and that safety was still in hand—are patently untrue.
In our previous debate on fireworks, also secured by my hon. Friend the Member for Northfield, the Minister for Competition and Consumer Affairs at the time, the hon. Member for Brecon and Radnor (Mr. Evans), when questioned about the impact of imported fireworks, said:
We have looked at whether imported fireworks have any role to play in terms of the increase in figures. We have no evidence of that at all."—[Official Report, I November 1995; Vol. 265, c. 272.]
Is it not tragic that the evidence was to come exactly a year later because that Minister failed to take action?
In the mean time, on 3 January 1996, as my hon. Friend the Member for Wakefield said, the coroner who looked into the death of his constituent Roger Robinson sent a damning letter to the Minister, communicating his findings. He said:
From the evidence recorded at this Inquest it became apparent that legislative controls are required for the sale of Aerial Shells … The likelihood of an accident involving a shell resulting in fatal injuries is unusually high.
The Minister present in the Chamber today, who acknowledged the letter, did absolutely nothing about it. When pressed by my hon. Friend the Member for Dagenham (Ms Church) on 17 July this year on the Floor of the House of Commons to impose a ban on aerial shell sales to the public, he again declined to take any action. It was of course only a few months later that two people were killed by that very type of shell.
The warnings to the Government have been legion. In 1994, the chairman of the National Fire Safety Technical Committee stated:
It would seem that if the current proposals go ahead, consumer safeguards will be lowered in an area where dangers are very well known and understood".
I asked for a meeting on 3 November 1994 with the then President of the Board of Trade, now the Deputy Prime Minister, to discuss the import and sale of category 4 fireworks following the removal of licences. The relevant Minister replied:
We have been assured by the Health and Safety Executive that this should not have any real effect on the safety of imported fireworks … I do not think that there would be much to be gained from a meeting.

The Association of Metropolitan Authorities begged Ministers for a meeting with its officials in October 1995. It took six months for DTI officials to meet representatives of the association and key enforcement officers.
The sad fact is that neither we nor the general public have any grounds for believing a word that Ministers say on this subject. We know that they are lying through their teeth on tax; they are also lying through their teeth on the control of fireworks—the deaths and horrific injuries clearly show that.
The abolition of import controls has been a deregulation disaster. My colleagues have clearly spelled out what now needs to be done. First, we must ensure that those who sell fireworks over the counter are held responsible for their actions—if over-the-counter sales are to continue. There must be some doubt about that. If the injuries continue at the current horrific rate and the public have to put up with the tremendous strain of bangers and other fireworks being let off in unrecorded public incidents, the future of such sales must be in doubt.
Furthermore, we must ensure that those responsible for firework displays are properly trained and licensed, and that dangerous fireworks such as aerial shells are not available to members of the public but are restricted solely to those who run professional firework displays.
On 16 October last year, the DTI issued a press notice to the public. It read:
Jonathan Evans warns: the best don't mess with fireworks".
The truth is that the best do not mess with firework regulations, which is precisely what the Government have done. The best do not sit on the Government Benches. The Opposition, on the other hand, intend to ensure that the British public get the best, safest firework legislation available anywhere.

The Minister for Competition and Consumer Affairs (Mr. John M. Taylor): I congratulate the hon. Member for Birmingham, Northfield (Mr. Burden) on securing this debate on an important subject. We are all aware that today's debate takes place in the aftermath of tragic deaths from fireworks this year. I know that the whole House is of the same mind in expressing condolences to the family and friends of young Dale Mitchell, Mr. David Hattersley and Mr. Steve Timcke. That serves to underline the serious issues that the Government have to consider.
As has been pointed out, there have been three deaths from aerial shells since 1994. Investigations are still continuing into the deaths of Mr. David Hattersley and Mr. Steve Timcke, and details are still emerging. It appears, however, that a significant factor in the two deaths was human error. Hon. Members will also recall the death in similar circumstances of Mr. Roger Robinson of Wakefield in 1994. In that case, no fault was found with the firework which killed him. I recognise and accept that this raises serious questions about the availability to the public of such powerful devices.
Nine-year-old Dale Mitchell died as a result of a fire started by a firework being put through the letterbox of the family home. I understand that the incident is subject to court proceedings. I have asked my officials to liaise closely with the authorities investigating the very different circumstances of each case so that we can learn the lessons from them.
The hon. Member for Northfield will be well aware that many of the matters he raised are already being considered as part of the Department's review of fireworks, and that I am giving these issues the serious attention that they deserve. As far as I am concerned, one person injured on bonfire night is too many. The answers that I have already given the House should leave the hon. Gentleman in no doubt that we intend to do what is sensible and appropriate. My priority is to arrive at a balanced judgment of what measures would be appropriate.
I hope that the House will bear with me when I say that fireworks give rise to a wide range of worries. I refer to hooligan behaviour, the purchase and use of fireworks by children, anti-social use late at night or over an extended period—all these have been mentioned. The hon. Member for Littleborough and Saddleworth (Mr. Davies) mentioned the link with alcohol, and I agreed with him about that. Then there is the question of training for the organisers of displays; carelessness on the part of non-professional users; the availability of certain shells which may be dangerous in the hands of the inexperienced; and badly made fireworks or those containing illegal mixtures. I should point out that import controls are relevant only to the last of those issues. All the evidence shows that badly made fireworks are a far smaller issue than most of the others I have mentioned.
Against this background, it can be seen that there is no quick fix, but I will instigate a thoroughgoing root-and-branch review of the regulations—I give the House that commitment.

Mr. Nigel Griffiths: The Minister appears to be committing himself to a further review. Why, then, after he received the letter from David Hinchliff, the West Yorkshire coroner, dated January of this year and specifically calling on the Minister to re-classify all aerial shells as category 4 so that they cannot be sold. to the general public—because the deceased in question was an "adult mature sensible person" who died as a result of human error—did the Minister not accept that advice and act on it in January, before bonfire night, thereby perhaps avoiding the subsequent two fatalities?

Mr. Taylor: The hon. Gentleman is aware of the letter that the coroner wrote to me and, I think, of my reply. The coroner's letter was a contributory factor in launching the review. The basis and framework of the review were laid down earlier this year, and it went public in July.
There are no quick fixes. Simply shuffling one kind of firework from category 3 into category 4 will not overcome all the problems that we face. I am not in the business of quick fixes; I want to be thorough. There have been changes in the market, with which I shall deal shortly.
At risk of saying it twice or three times, I do not intend to rush into knee-jerk measures that might be effective for a short period and attract congratulatory headlines, but encourage an uncontrolled black market in fireworks in the longer term, as has been the case in some countries that have strict legal controls.

Mr. Burden: I know that the Minister is short of time, so I will not detain him long. No one is asking for a quick fix, or saying that he should not carry out a review,

but after three deaths in a three-year period, what more evidence does he need to ban aerial shells from public sale for a temporary period under the powers available to him, while a thorough review is carried out? Let us get them off the market and make sure that people are safe. The Minister can have his review and, if it is proved that such fireworks are safe, let him bring them back, but for goodness sake let us not have any more deaths in the meantime.

Mr. Taylor: The hon. Gentleman returns to the point that he made when he opened the debate. I will reflect on it, but I shall not oblige him here and now in the Chamber. I want to press on, as I have only nine minutes left to reply on behalf of the Government to what I consider to be one of the most important Adjournment debates for a long time. I hope that the House will allow me the opportunity to reply.
Let me assure the House that the Government take the matter very seriously indeed, as I have made clear by undertaking the comprehensive review, which 1 will see through. My reasons for instigating it are well documented—and shared by a number of hon. Members. The review was initiated earlier this year, well before 5 November. The reasons behind it are manifold: growing concern about the great variety and power of fireworks available to the general public; the increasing number of fireworks sold and the way in which they are used; the changed structure of the market in fireworks; the nuisance that they can cause to people, especially the elderly and, as the hon. Member for Sheffield, Heeley (Mr. Michie) rightly said, to animals; and the elevated level of injuries over the past two years.
The consultation document issued by my Department was, I believe, the most detailed explanation of the controls on fireworks and the most comprehensive attempt to seek views on a range of important firework issues since the review undertaken in 1975, to which the hon. Member for Northfield referred. The 1975 review resulted in the endorsement of a set of voluntary controls instituted by the firework industry. I took the view, shared by others, including many in the firework industry, that the time was past when those measures could be considered sufficient to offer adequate safeguards to the public.
A number of issues were raised today. Much has been made of the removal of import controls. I shall deal with that once and for all, before turning to other matters. The change to the authorisation system was not rampant deregulation, as the Opposition claim, but a sensible bid to establish a more thorough and equitable system that applied to both domestic and imported explosives.
In 1993, the combined effect of changes to border controls arising from the completion of the single European market, and the need to implement the explosives for civil uses directive, necessitated some change in the existing system. That directive did not apply to fireworks. However, the Health and Safety Commission took the view that a uniform system covering all explosives, including fireworks, from all origins, both member states and third countries, would have safety benefits. The implementing regulations were therefore used as a legislative vehicle to strengthen and clarify existing authorisation procedures and remove import controls.
The current authorisation regime has certain advantages over import licensing controls. At the time of its removal in 1993, import licensing did not require checks on every


consignment brought into the country or routine testing, as hon. Members seem to believe. From 1987, licences were issued for up to five years and spot checks were made, as they are now, under the authorisation system. An import licence was issued for any firework that fell into the appropriate United Nations classification, which was very broad. The new system uses specific names which provide more precise information to enforcement bodies.
The import licensing scheme required only that a firework complied with British standard BS 7114 before final distribution. Accordingly, fireworks could be imported in a state that did not comply. There was no distinction between fireworks intended for the public and those for professional use. The import licensing scheme did not specifically prohibit dangerous admixture, which authorisation does.
A major advantage of the authorisation system is that compliance can be checked at any time, rather than solely at the time of entry.

Mr. Sheerman: Is the Minister saying that the Government did not deregulate, and that if anyone is responsible, it is not the Government but the Health and Safety Executive? Is he saying that the flood of cheap and dangerous fireworks from China that are sold with no instructions in English are nothing to do with the Minister? If so, ministerial responsibility is dead and I, for one, mourn its passing.

Mr. Taylor: That is a rather intemperate way of putting a question that is well worth answering. The issue of imported explosives is not, so to speak, black and white. The Chinese—I say this with the greatest caution—probably have more experience with fireworks than any other culture on the planet. The other factor that does not lend itself to a black and white interpretation is the fact

that some of the biggest importers of firework material from China are domestic manufacturers. The issue is therefore more complicated than the hon. Gentleman's question suggests.
There are two other aspects to be taken into account in considering what the hon. Gentleman might choose to call deregulation. The import licensing regime was replaced in 1993, but the Health and Safety Executive—1 associate myself with this—says that the single authorisation scheme, which is much more flexible, and which replaced it, in no way weakens safety controls.

Mr. Nigel Griffiths: It has.

Mr. Taylor: We differ about that.

Mr. Griffiths: Look at the figures.

Mr. Taylor: With two minutes to go, I am not sure how useful it is for the hon. Gentleman to intervene on me from a sedentary position. I have not yet finished dealing with the question about deregulation, as the Opposition choose to call it. I mentioned import licensing and its replacement. The second aspect is the revocation of the 1986 firework safety regulations, which took place in 1995 and has not weakened the hand of trading standards officers. Local authorities can authorise trading standards officers by simple resolution, and mark their warrant accordingly in these particular areas of activity. In those circumstances, trading standards officers can prosecute retailers.
The present authorisation system applies to imported and home manufactured fireworks alike. Suppliers will be in breach of the law unless each and every item that they supply fully meets the published criteria set by the Health and Safety Executive's explosives inspectorate.
I am beaten by the clock, but I would like to offer to all hon. Members present a letter that will cover any unanswered questions.

Social Services (Lancashire)

11 am

Mr. Nick Hawkins: On 22 November 1995, my hon. Friend the Member for Blackpool, North (Mr. Elletson) was fortunate—in the same way as I have been this morning—in obtaining an Adjournment debate on the subject of social services in Lancashire, which was responded to by my hon. Friend the Member for Battersea (Mr. Bowis), who was then the Minister responsible.
My hon. Friend the Member for Blackpool, North drew attention to the catalogue of incompetence and mismanagement of social services by Labour-controlled Lancashire county council. My hon. Friend the Minister ensured that a report into the position in Lancashire, with particular regard to community care, was made by the social services inspectorate. That report contains some very serious criticisms. In particular, the summary of the report said:
Management of the process gave cause for concern … Measures to contain spending and target resources have been unpopular and not always carried out smoothly or equitably across the county … The Council's home care policies give an initial preference to in-house services
and so on.
Those criticisms were brushed aside by the Labour councillor who chairs the social services committee of Lancashire county council, who bears the staggeringly inappropriate name of Councillor Humble. The one thing that none of us on the Conservative Benches has ever seen from Labour councillors in Lancashire is humility. They are completely unapologetic about all the many sins of commission and omission for which they have been responsible.
Yesterday, as a further sign of how much is wrong with the Labour party in Lancashire, my right hon. Friend the Member for South Ribble (Mr. Atkins) drew attention during Prime Minister's Question Time to the recent revelations in the past few days about systematic fraud and corruption in Labour-controlled Preston council. None of this comes as a surprise to any of us on the Conservative Benches, and all those matters are connected. There is a seamless web of connections between the main Labour-controlled borough councils in Lancashire and the Labour group on the county council.

Mr. Robert Atkins: Is my hon. Friend aware that some of the people mentioned in the auditor's report to which I referred yesterday are members not only of Preston borough council but of Lancashire county council?

Mr. Hawkins: As my right hon. Friend says, in some cases they are the same people; in others, for example, there will be a husband on the county council and a wife on one of the borough council Labour groups, or other forms of "partners" that the Labour party so often go in for, with one partner on the county council and another on the borough council. The connections are closest between county hall in Preston and the Labour Lancashire county councillors who run personal empires from there, and Labour councillors on Preston borough council. There is much that is rotten in the state of Lancashire, and all that is rotten is Labour.
I now come to the specific effects that this has on the people who are unlucky enough to have to rely on the appalling Labour-controlled county council for care when they need it. What are the details of the huge amounts that Lancashire county council has been provided with—out of taxpayers' money—by the Government to spend on social services? In 1990–91, Lancashire county council had £92 million. By 1993–94, this had risen to £147 million. In 1994–95, it was £169 million—up £22.6 million in one year—and by 1995–96, it was £185 million.
How has Labour-controlled Lancashire county council organised its affairs given those huge amounts? In 1993–94, the county council underspent by £6.3 million. The Conservative group on the county council wisely recommended that that be carried forward. Instead, Labour put it into its general balance for other use—or, more likely, misuse. In 1994–95, the county council found that it had miscalculated so badly that it faced a possible overspend of £14 million. Its response was to withdraw home help services.

Sir Mark Lennox-Boyd: My hon. Friend should be congratulated on mentioning that point. He will be aware that many of the elderly and others in my constituency have suffered from those cuts. He mentioned the cut in the social services budget of £6 million in 1993–94. Perhaps he will go on to deal with the figures, but I invite him to comment at this stage on the fact that it was also cut by £3 million in 1995–96. I understand that there is a large underspend this year. I find those cuts quite unacceptable and I should be grateful for his comments. Does he agree that the only explicable reason why the county has done this is to build up a war chest for next year's council elections?

Mr. Hawkins: My hon. Friend makes an important point. One is bound to be suspicious, in the light of history, of precisely why those sudden cuts were made, and it is our constituents who are suffering. There is undoubtedly political gerrymandering going on with the budgets. I know that my right hon. Friend's constituents have suffered badly. Independent evidence shows that damage has been done in many parts of Lancashire—a point that I shall come to later.
We have covered all of this in the House before, but more scandals continue to crop up. There was the scandalous overspend by Lancashire county council on a new social services home in Bold street, Blackburn. It spent so much on that—about £240,000 to £260,000 for a small number of residents, at a cost of about £26,000 per resident, while there was a vast increase in the budget for social workers—that it became a byword for the incompetence of the social services committee, which refused to use the vastly cheaper but much better provisions in large private sector care homes in Lancashire. Many of the people who provide private care home facilities are members of the excellent Lancashire Care Homes Association, which has done its best to present their case for greater use of their facilities.
The scandal of the hugely expensive home in Bold street, Blackburn came to light because of the diligence of a Conservative councillor in Blackpool, John Woolley, who was presented at a different committee with a large—in his view excessive—claim by a Lancashire county council social worker for a big increase in travel


allowances. Councillor Woolley rightly kept digging until he uncovered the whole story. So often, at Labour-controlled Lancashire county council, it is a case of jobs for the boys and jobs for the girls.
The debate grows mostly out of the latest scandal from which some of my constituents have suffered personally. Mr. and Mrs. Gardner of Knaresborough avenue, Blackpool have a son, David, now aged seven. David, sadly, suffers from cerebral palsy and needs a lot of extra care. The Gardners have had a lot of help from charities, especially Scope and the Leonard Cheshire Foundation. Unfortunately, they have been among the many families who have been badly let down by Lancashire county council social services. The biggest problem has been a lack of continuity of care for David. As the Gardners have said to me in their many visits to my surgeries over the past year or more as the case has developed, every time there is a change of social worker, the plans for what the social services department offers to provide seem to change.
The only part of Lancashire county council that seems to work properly and has helped the Gardners is the welfare rights service. I give credit, on behalf of the Gardners and other constituents, to the genuine help that Alun Pugh, Jim Dickson and their team have given, for which they were rightly recently awarded the Government's charter mark.
The Gardners, however, have not been so fortunate with the social services at Lancashire county council. Despite their general practitioner, Dr. Morrison, writing a strongly worded letter to social services at the end of 1995 urging continuity in the care facilities provided for David, the plans have continued to change. There were all sorts of problems with David's speech therapy service, but the most important feature of the case was the proposed changes to the service provided for David at his home.
Frustrated with this long saga, I decided to take up the matter with the Leonard Cheshire Foundation, which was involved in providing much of David's at-home care. The council wanted to withdraw that care and I thought it was important, not only for the Gardners but for so many of those whom we represent in Lancashire, to seek an independent, unimpeachable view from a charitable source about the case and about the general picture of Lancashire county council social services provision.
I was delighted to receive an extremely detailed letter on the subject, from Martin Perona-Wright, director of services in Lancashire for the Leonard Cheshire Foundation. He said:
All the staff, Manager. supervisors and care attendants who have been involved with the care of Mr. and Mrs. Gardner's son David, share the considerable concern about the future. Continuity of care and choice by the client appear to be of secondary importance to financial considerations. We operate in Lancashire against the competitive backcloth of a policy which refers every client in the first instance, to their own Home Care service".
That is the county council's service. Conservative Members constantly make that precise point and my hon. Friend the Member for Blackpool, North referred to it in his Adjournment debate in late 1995. The letter continues:
The Local Authority service—which is not subject to the same rigorous annual Inspection, which the LCF Care at Home Services in Lancaster and Blackpool have recently undergone—can therefore

cherry pick the services and clients to whom they wish to provide a service. Charities such as this suffer from lack of continuity—plenty of early morning, evening and weekend work"—
in parenthesis, I point out that those are the times when it does not suit social workers to work—
but little cost effective continuous Monday to Friday care. Small wonder we are deemed to be expensive!
On the specific case, Mr. Perona-Wright goes on to say, on behalf of the charity:
If left to this organisation and it were the wish of the Gardners, we would be willing to continue David's care and support, despite the fact we provide a quality of input and care in excess of that purchased by the Local Authority. (What about the principle of direct payment and/or topping up for domiciliary home care services—has either of these practicalities been discussed with the Gardners? The answer is in the negative because neither feature has been adopted by Lancashire County Council Social Services Department!). We have only today"—
the letter is dated 22 October—
been verbally"—
I stress, not even in writing—
informed that our services are no longer required from the 2nd November and no reasons have been given for the change.
That major charity was given about 10 days' verbal notice that everything was about to change. Mr. Perona-Wright goes on:
You might find the attached extracts from the booklet 'Community Care in Lancashire—Your Charter' useful. I have marked those statements which appear to be being breached in this case".
The social services department document, "Information about Community Care Services", contains all sorts of fine words. It states:
If it is agreed that you will receive services to help you stay in your own home you can expect:
that the detail of the service and the arrangements for its provision will he discussed with you. Your preference is taken into account.
As Mr. Perona-Wright says, there was no question of preference in this case. The document goes on to say:
that disruption in the established pattern of service will be kept to a minimum.
There is no question of social services sticking to that aim in this case. The document goes on:
Community care aims to put service users and their carers first. In any dealings with community care services you can expect:
to have an opportunity to present your views in any assessment of your needs".

Mr. Harold Elletson: Does my hon. Friend agree that social services brochures and documents are unreliable? Does he recall the document that I produced in last year's social services debate which featured my constituent Geraldine Robinson on the cover? She suffers from cerebral palsy and was told that, as a result of Lancashire county council's mismanagement, her budget for domiciliary care would be cut from £700 to £300 per week and that her 24-hour care package would be reduced to only 34 hours of care per week. That is disgraceful.

Madam Deputy Speaker (Dame Janet Fookes): Order. The hon. Gentleman is making a short speech. Interventions, by their nature, should be short.

Mr. Hawkins: I am grateful to my hon. Friend and I pay tribute to the way in which he continues to pursue—


as all Conservative Members seek to do—the manifold sins and wickednesses of Lancashire county council under Labour. It is extraordinary that both my constituent's case, which I am highlighting today, and the case raised by my hon. Friend involve cerebral palsy sufferers. The Labour group on Lancashire county council social services committee appears to have learned nothing from my hon. Friend's splendid debate, to which many hon. Members contributed, in November 1995.

Mr. Atkins: Conservative Members of Parliament from Lancashire are conscious of the importance of this case in raising the profile of the debate. Does my hon. Friend accept that Conservative Members who represent Lancashire constituencies each week come across instances of the council's churlishness, incompetence, downright rudeness and its failure to care about people who need attention? That is a most damning indictment of Lancashire county council.

Mr. Hawkins: I could not agree more with my right hon. Friend. About half the cases presented at my surgery each week relate to complaints about Labour-controlled Lancashire county council social services. The real problem is the difference between the fine words in the pamphlets and the actions of the social workers on the ground—the two simply do not match. All the fine words in the world will achieve nothing if the actions do not deliver on the promises.
In Lancashire county council social services documents, one sees not only fine words but political propaganda. I have an official social services document that is supposed to be factual. The document about financial assessment entitled, "Guidelines for Completion of FIN 96", refers to cutting home help services almost overnight—a point that my hon. Friend the Member for Morecambe and Lunesdale (Sir M. Lennox-Boyd) mentioned earlier. In the third paragraph, it states:
However, they"—
that is, the social services committee—
were mindful of the Government under-funding of Community Care".
That assertion is not only inaccurate and disgraceful, but political propaganda presented in a supposedly official form about financial assessment. We must continue to highlight that sort of disgraceful behaviour.
I shall complete my quotations from the letter from Mr. Perona-Wright, the director of services in Lancashire for the Leonard Cheshire Foundation. He concludes:
I hope these comments will help you pursue the Gardners' case. One would like to see"—
as we all would—
the interests of individuals—particularly those with disabilities—and their families being of paramount focus. Regrettably in this instance David's best interests appear not to be being served by an unnecessary and enforced change of carer agencies—a change to which no-one, apart from Social Services personnel, appears to subscribe. Please do not hesitate to come back to me if you feel I can be of any further help.
I immediately faxed that letter to social services, which picked up one or two minor details in its reply but failed to address the substance of the points raised.
However, there was good news this week for the Gardners, who applied for a review of their son's case. My Conservative colleague, John Woolley, the county and

Blackpool borough councillor, presented the Gardners' case at the hearing and he managed to win the review on their behalf on Monday. I pay tribute to his achievement. It was a case of the social services department maintaining its fixed opinion in opposition to the views of the charity that was involved in the child's care and against the interests of the family. The Gardners managed to retain that care only through the diligence of a Conservative councillor. That case is yet another object lesson in the practices of Lancashire county council.

Mr. Atkins: The council's reaction to an independent charity is not confined to social services. In education, the county council has refused to accept the existence of dyslexia, and has ignored the specialist, charitable and professional advice of Conservative Members' constituents about children with dyslexia.

Mr. Hawkins: My right hon. Friend makes an excellent point about dyslexia, which relates closely to the David Gardner case, because one of his problems was with speech therapy. Under Labour, Lancashire county council constantly lets down the people whom it represents.
I was extremely grateful to my hon. Friend the Minister when, shortly after he took up his new post, he sent us a copy of a letter, which he had sent to the deputy clerk of Lancashire county council, headed:
Implementation of Community Care in Lancashire".
I pay tribute to the Minister for stressing that it was essential for Ministers to know what action the authority was taking to address the issues covered in a previous letter that had been sent during the summer. The Minister wrote:
Those were serious concerns requiring a constructive response. I look forward to receiving a full account of your action plan".
It is essential that we keep up the pressure.

Mr. Keith Mans: Does my hon. Friend agree that, although Lancashire county council received the Minister's letter asking what it was going to do, there is little evidence that it is doing a great deal? Indeed, rather than doing anything, it is prevaricating and stretching matters out so that none of the recommendations is implemented.

Mr. Hawkins: My hon. Friend is right. The purpose of today's debate was to keep up the pressure and to draw attention—as my right hon. and hon. Friends have done—to the fact that Lancashire county council seems to take no notice of evidence from charities, of what people who need care say and of what Ministers or the social services inspectorate say. We have had repeated reports from the social services inspectorate and the district auditor containing savage criticisms of Labour-controlled Lancashire county council.
To emphasise the final lesson to be learnt, I shall use some of the words that were used by another party in the past. Under Labour, do not be old, do not be young and disabled, do not be any age and disabled and do not suffer from cerebral palsy, because all that the Labour party will do is publish fine words in expensive brochures, provide social workers with huge travel allowances and increase the budget for, and the number of, administrators at county hall. The one thing Labour will not do is provide


people with care. The country should know that Labour in Lancashire shows what it would be like if the country were ever unwise enough to elect a Labour Government. Do not be old, disabled or young and in need of care, because Labour will provide only glossy brochures and highly paid social workers, but no proper care when it is needed.

Mr. Peter L. Pike: I am glad to have the opportunity to speak in this debate and to paint a different picture from that painted by the hon. Member for Blackpool, South (Mr. Hawkins). Whatever the hon. Gentleman's fate may be, he will not be a Member of Parliament representing a Lancashire constituency after the general election. He has chosen the chicken run and has fled Blackpool before he loses his seat at the next general election.
It is a tragedy that every time Conservative Members initiate a debate about Lancashire, all that they do is to attack, criticise and paint an untrue and misleading picture. They know that I am a strong supporter of unitary local government. I would like Lancashire county council ultimately to go, and social services to be provided at borough council level. Having said that, I fully support the work of Lancashire county council. It does an extremely good job, and social services is one of the important services that it provides.
It was regrettable that the hon. Member for Blackpool, South and the right hon. Member for South Ribble (Mr. Atkins) chose to have a totally unjustified go at Preston borough council. Their allegations against Labour councils, including Burnley—their allegations went wider than Preston—were unjustified. I hope that they will repeat some of their remarks outside the House. Whatever the criticisms in the report that was published on Monday, the leader of Preston borough council, David Borrow, and his predecessor, Valerie Wise, are most anxious that any allegations against officers or members of the council are fully investigated, even if they concern activities which took place eight or nine years ago.

Mr. Atkins: The hon. Gentleman mentioned me by name and yesterday I asked the Prime Minister a question about Preston borough council. If the hon. Gentleman has seen the independent auditor's report, he will know that the criticism was directed specifically at Preston borough council—I made no allegations against Burnley or anywhere else. Labour councillors and some officers were accused of, among other things, corrupt and criminal practices. I do not care when that was: Labour was in control whenever that took place, and it has cost Preston taxpayers millions of pounds.

Mr. Pike: I accept what the right hon. Gentleman says. Conservative Members criticise Labour councils, but they do not make the same criticisms of Westminster council, which has been severely criticised for its actions. I do not condone any wrong actions by Preston borough council, but its present leader and his immediate predecessor have strongly condemned the actions that have been criticised. The hon. Member for Blackpool, South said that this case was typical of Labour authorities, and he made serious allegations. I accept that the right hon. Member for South

Ribble yesterday and in his intervention today referred specifically to Preston, so my comment about Burnley did not apply to him.
I agree with the right hon. Member for South Ribble about the welfare rights services, which received a charter mark earlier this year. I pay tribute to Paul Burgess and his team throughout the county, and to Richard Roxburgh, an officer in Nelson, with whom I deal on many local issues. They provide an excellent service to the people of Lancashire.
The hon. Member for Blackpool, South has rightly taken a strong interest in the Gardner case. The individuals involved had a right of appeal. In the latter part of his speech, the hon. Gentleman said that that had been dealt with earlier this week. They exercised their right of appeal, and on that appeal panel were two Conservative and one independent councillor. Under Lancashire county council's system, people are entitled to have their case reviewed by an appeal panel if they are not satisfied with the way in which it has been dealt with. The criticism of the council in that case is unjustified.

Mr. Mans: Will the hon. Gentleman give way?

Mr. Pike: I want to be brief, so I hope that the hon. Gentleman will make a short intervention.

Mr. Mans: The hon. Gentleman mentioned unitary authorities and Lancashire county council. Does he believe that elderly people, especially those in Burnley, would be better served if their social services were provided by his authority rather than by the county council?

Mr. Pike: I do not believe that. I think that services are better provided locally. The hon. Gentleman knows that I am strongly in favour of unitary local government, and that it is the Conservative Government who set up the local government review which made a mess of it. It proposed a hybrid solution—the worst possible solution for Lancashire—with Blackpool and Blackburn being taken out. That is a great tragedy. But let us not get side-tracked on to that debate: let us keep our minds on the important issue of social services. Social services and education are the two major services provided by the county council.
The hon. Member for Blackpool, South mentioned the social services inspectorate report which followed a previous debate. In a press release dated 20 June, Louise Ellman, leader of Lancashire county council, said:
The Government commissioned this report after a so-called Parliamentary Debate in which no Labour MPs were allowed to speak. The report says that the justification or otherwise for the complaints concerning bias in residential care have not been substantiated.
As that press release suggests, the tone of the report was very different from that of the hon. Member for Blackpool, South.
In a later press release, Joan Humble, the chair of social services, said:
The Social Services Committee maintains a continuing review of the arrangements for social care services in Lancashire taking account of recommendations made and the guidance provided by the Department of Health and the Audit Commission. This will continue and a clear focus will be kept on the needs of the most vulnerable people in Lancashire's community.

Mr. Hawkins: In her press release, which the hon. Gentleman read out, the Labour leader of Lancashire


county council, Mrs. Louise Ellman, referred to a "so-called parliamentary debate". What sort of approach is that from the leader of a Labour authority who has been chosen as a prospective parliamentary candidate for Labour, and who aspires to come to the House? We would remember that when the lady became a Labour Member of Parliament, were she to be successful.

Mr. Pike: I think that the phrase "so-called debate" is justified when it refers to a debate in which no one is allowed to express a different point of view. The simple fact is that no one was able to express a contrary view in that debate—so it was not a real debate, allowing both sides of the case to be heard.

Mr. Elletson: Will the hon. Gentleman give way?

Mr. Pike: No, I will not.
The social services inspectorate undertook an analysis of in-house services, which was published in June. It examined allegations made about community care in Lancashire. The hon. Member for Blackpool, South painted a misleading picture: the report certainly does not constitute the damning condemnation that Conservative Members have tried to portray. It showed that levels of overall service remained comparable with, or higher than, those in similar local authorities; that there was rapid growth in purchasing from the independent sector, at a level exceeding the average for other similar local authorities; that there was rapid expansion in the purchase of domiciliary services from the independent sector, from zero in 1993 to £11 million in 1995; that, in home care services, the growth of the independent sector had exceeded that of the in-house service; that the market share of independent nursing and residential homes in Lancashire had been consistently higher than the average for shire counties and England overall between 1993 and 1995; that, subject to the availability of resources. there was a wide range of choice and flexibility for users; and that the level of resources committed to management and administration was unexceptional compared with that in other counties.
According to the analysis,
the report fails to substantiate allegations made that there is any systematic bias towards the use of in-house residential services but instead shows that the Government Direction on choice between public and private sector residential care has been complied with".
That view of the report is very different from the view expressed by the hon. Member for Blackpool, South and other Conservative Members.
In-house services are clearly long established, and people still have confidence in them. I have visited a number of private homes: I undertook two tours during the summer recess. Some of them provided an equally good standard of care. I always say that the standard of a home cannot be judged by the carpets, curtains and wallpaper—not that those are unimportant, but I am sure that we all agree that the most important aspects of the care of elderly people are staffing and the attention given to those people. We must make the maximum use of the homes that we have; it would be absurd not to do so.
Let me say a little about charging policy. Lancashire county council has suffered severe financial restraint. Let us make no mistake: because of capping and other financial limitations, and the area cost adjustment—which

has caused it major problems—the council has not sufficient money to provide the services that it would like to provide. Finance and Government are responsible for the problems, and the form to which the hon. Member for Blackpool, South referred was entirely justified in pointing that out.
The council was forced to make major cuts. One way of minimising those cuts was the introduction of a charging policy, which reduced the cuts by bringing in some money. The council tried to introduce the simplest and fairest possible system, and the level of charges is comparatively low.

The Parliamentary Under-Secretary of State for Health (Mr. Simon Burns): If Lancashire county council felt that it must make cuts because of a lack of financial resources, why did it underspend its social services budget by £1.94 million in 1993–94? Can the hon. Gentleman also explain to me, and to the people of Lancashire, why it underspent the budget by £3.4 million in 1995–96?

Mr. Pike: There have been so many changes in financing that it is difficult to adjust to those changes quickly.

Mr. Burns: What!

Mr. Pike: The Minister ought to be very careful. The hon. Member for Blackpool, South referred to a letter that he had received from the Minister, but the Minister chose to send that letter only to Conservative Members representing Lancashire seats. Why did he not send it to all Members of Parliament? He accused Lancashire county council of being political. I consider it very political of the Minister to choose to write—

Mr. Burns: Answer the question.

Mr. Pike: Let us deal with my point first. I am making my speech; the Minister will make his in due course. Was it not political of the Minister to act as he did? He should have written to all of us, to let us all see exactly what he is saying to Lancashire county council.
I know that my hon. Friend the Member for West Lancashire (Mr. Pickthall) will be dealing with these matters, but, in fact, Lancashire county council has used the money that it did not spend, having carried it forward. It believes that it is on target to spend this year's budget; indeed, there is no doubt that that is so. But to criticise a marginal underspend—[HON. MEMBERS: "What?"] It is a very big budget, and the circumstances are extremely difficult when the position is changing all the time.

Mr. Burns: Will the hon. Gentleman give way?

Mr. Pike: No, I will not give way to the Minister again.

Mr. Burns: rose—

Mr. Pike: Go on, then.

Mr. Burns: I am grateful to the hon. Gentleman. I appreciate that he is floundering, and I do not want to


cause him undue embarrassment, but will he be kind enough to explain why there was an underspend in those two years if resources were so tight?

Mr. Pike: The underspend was 1.78 per cent. I accept that no one wants an underspend—

Mr. Burns: Why was there one, then?

Mr. Pike: There are many reasons. The social services position is changing all the time.

Mr. Burns: No.

Mr. Pike: What the Minister says is entirely unjustified. In the previous year, there was a £230,000 overspend. Is the Minister saying that that was wrong? Is he saying that the spending of every Government Department is exactly on target each year? We have been looking at the Chancellor's figures for this year. There has been great variation in the public sector borrowing requirement, for instance.

Mr. Elletson: Will the hon. Gentleman give way?

Mr. Pike: No, I will not. The hon. Gentleman was not even present at the beginning of the debate—he came in late—and other hon. Members want to speak.
The charges are low compared with those of many other local authorities, with 56 per cent. of service users paying only the minimum rate of £1.55 per week. If the county council had not introduced charges, it would have had to make more cuts. The Minister may feel that the council has sufficient overall resources. That is not true. It needs more financial resources and a greater continuity of budget.
Year after year, the Government change the rules. Year after year, they cut further and cap the county council. Now is the time for the council to ensure that people can receive the services that they want. It will be able to do so when we have a Labour Government who at last recognise the importance of social services and of local government.

Mr. Den Dover: It gives me great pleasure to reinforce the views of my hon. Friend the Member for Blackpool, South (Mr. Hawkins) because, in the 17 years that I have represented Chorley, Lancashire county council's social services department has been very uncaring. It has not controlled its budgets. It has not been efficient. In correspondence, it produces all sorts of warm words, but my constituents have been disappointed by its performance, particularly in the past couple of years.
It is unacceptable for the social services department suddenly to impose a respite home on the high-class residential area of Long Copse in Astley village in my constituency. No notice was given. There will be tremendous extra usage of resources, extra traffic and unacceptable noise and disturbance to residents in an area that is unsuitable for such a home. At the same time, I told county council officials that a disused building would have been admirable for the purpose and was within a

mile of the council's chosen site. There was a need to do something about the building and to provide—I do not want to stop respite care in the community—facilities where they are needed, not in a high-class residential area. That is typical of the bureaucratic and remote services operated by the county council.
Mention has been made of residential homes and of whether provision for people who need such a service should be made in-house by Lancashire county council or by the private sector. Much of the underspend this year and two years ago occurred because the council was reluctant to place spending in private sector hands.
In that connection, there is a dramatic increase in costs. In-house residential care costs an extra £93 per resident per week, more than in the private sector. That gives rise to a difference in cost of —10 million annually between the public and private sectors and it is one reason why we do not receive best value for money from the council. The standard home care service—domiciliary care—would cost £5 million more if provided in-house rather than by the private sector. That is about £15 million straight away. Compare that with the education spend and the policy statements issued by the Labour-controlled county council in the past few years, saying that there will be cuts in education spending and in the school budgets.
We have heard about the underspending. As in the past, the county council has raised a supplementary rate with no prior notice, which was damaging to individuals and businesses. As they did then, councillors have put the money from underspending into reserves so that, just before county council elections and the probable general election on 1 May, they can show what good, honest citizens they have been on behalf of county council residents and say, "We are going to reduce this and reduce that." I should like to think so. I think that the council will be pressing for that, but let us await events.
It is crazy that, as I said, the county council says, "We need cuts, cuts, cuts in education. We cannot give enough funds to schools," and then calls for an enormous rise of hundreds of millions in the education budget and of tens of millions for education spend in Lancashire.

Mr. Atkins: Did not the Leader of the Opposition and the shadow Chancellor of the Exchequer make it clear, as my hon. Friends will recall, that, if there were to be a Labour Government, there would be no extra funds for local government? Why therefore are Labour Members saying that more money should be spent when, if they were to form a Government, they would not be making such provision? It therefore depends on Conservatives and a Conservative administration in the county—if that is what happens—being more efficient.

Mr. Dover: I agree entirely, and it is yet another example of Labour saying one thing and doing another, or intending to do another.
If there is not enough money in the county council, why underspend on social services? Why not divert funds to education? Why the enormous brouhaha and cry for an area cost adjustment investigation, and what has that shown? Lancashire is overfunded compared with, say, Cheshire. If there were a change because of the academic and independent research, Cheshire would gain, Lancashire would lose and, guess what, we would be subjected to less education and school spending.


The county pressed for the investigation. Now that it has the independent results, it does not accept them or want any changes. It wants the whole thing scrubbed.
We shall see what happens. I hope and am optimistic that the Chancellor of the Exchequer will put education at the top of the spend, as we have in the past with social services and community care. After all, Lancashire started off with the largest community care budget in Britain, and that has been frittered away over the years by inefficiency.
A few months ago, Marylands residential care home on the A6 main road in Chorley was closed. Many of the home's clients had no prior warning. There had been an appeal and a tribunal finding. They rightly telephoned me that day to say, "Why is it that our parents"—or grandparents—"are having to be moved out with no notice?" I should like that to be investigated because it is unacceptable.
As we all know only too well, recently, the home help and care assistance service was massively adjusted by the county council, to the detriment of elderly citizens. I pay tribute to the self-supporting attitude of elderly residents in my Chorley constituency, who are typical of Lancashire and who look after themselves as far as possible, but they need help and assistance, yet that has suddenly been withdrawn.
On 29 August, I wrote to the director of social services to say:
I understand that recently you have reversed many of the decisions regarding home helps and care assistance—and I greatly welcome this.
I thought that there had been a change of mind, that the county council had realised that it was overspending, had cut here and there and had uncaringly ditched the needs of the elderly. I thought that things were looking up, but no. I received a reply on 10 September from the director of social services, which said:
I have not reversed any decisions and neither, to the best of my knowledge, have any other senior officers. Some individuals who had home care services withdrawn or reduced in the past have sought re-assessment of their care needs—as they have always been able to do—and in some cases the social care assessment has indicated a current need for services which have then been arranged. I am aware that this has been described in some quarters as a reversal of decisions but that is not an accurate description, and the
number of cases quoted appears to be inaccurate.
I thought that my praise and thanks would be reciprocated and that I would receive a sensible reply. Surely to goodness, it should not be up to the media and Members of Parliament to bring about a change of mind by the county council, in the interests of our constituents. The unacceptable situation in which services were withdrawn should never have occurred.

Mr. Hawkins: Does my hon. Friend agree that one of the difficulties is that, although—as we all accept—there are some dedicated officers working for the county council, they are constantly constrained when trying to help, by the political direction that they receive from the Labour leadership of the county council social services department, and by the type of policies that led to the unacceptable political propaganda that I mentioned earlier? Even the most dedicated people, who are genuinely concerned about caring, simply are not allowed by their Labour political masters to deliver that care.

Mr. Dover: That is borne out by a reply that I received from the director of social services. I said to her, "If you

have been underspending this year and for the past two years, you must have built up reserves." She was completely unaware of any reserves, although she is looking into the matter. It shows that the officials are working as best they can, but their political masters are saying, "Do something totally different from what you really want to do."
Another example of the social services department's inefficiency concerns my constituent, Valerie Smith. Unfortunately, about 10 years ago, she lost a child in a road accident, and because of shock and mental disorder, she was in the sad situation of having another child taken away from her. After all those years, the county council suddenly wrote to her to say, "Your child has been adopted." That caused her great mental anguish, because she thought that she had rights of access and that, having proved that she was improving, she could have the child back. She then received that letter and thought that she would not be able to get her child back. However, the council then wrote to say, "Sorry; we made a mistake when we said that your child had been adopted." That is typical of inefficiency in the county council social services.
Cerebral palsy has been mentioned in the debate. Alice Allen, of Chapel lane, Chorley, is six years old and severely disabled from cerebral palsy. The county council social services issued only one orange badge to her family, although her parents work 26 miles apart from each other. Their routine is that one of them will take Alice to the centre in the morning and the other will pick her up at night. Quite rightly, they raised the issue with county council social services, but the response was, "The situation is very difficult. The rules say this and the rules say that." Senior county council officials should use their discretion to be responsive to the wishes of constituents and to issue a second badge in such cases, so that proper care is seen to be meted out to my constituents.
The purpose of the debate is to show that the county council social services department has an uncaring attitude. That is not a sudden development—Labour has controlled the council for the past 14 years—but the situation has been getting worse. It has been a long time since there was Conservative control of the council, and a caring attitude by the council.

Mr. Atkins: I am extremely grateful to my hon. Friend. He is providing us with a list of the problems that he and many other Conservative Members are experiencing. Does he agree that the response that we receive from the county council social services department is not always what we would wish it to be, and that a small improvement would make the management of our constituencies and action on behalf of our constituents that much easier?

Mr. Dover: I agree entirely. Perhaps it is time for the department to re-examine its arrangement of local offices and to ensure that care is available locally. Occasionally it is necessary to reorganise. I agree with my right hon. Friend that it would be better if we had more local offices, and more local officials controlling what is happening and responding to local requirements.
We do not like raising the issue of problems in social services, but we are pressed constantly by our constituents, in our surgeries and in letters, about them.


That should not be the situation. The Government have allocated more than enough money for social and education services, and for all the county and borough council services. We expect high-quality and caring services—particularly social services—and we want to ensure the best value for money. We have not been achieving those goals. I look forward to hearing the Minister's response.

Mr. Peter Thurnham: I congratulate the hon. Member for Blackpool, South (Mr. Hawkins) on his success in obtaining this Adjournment debate, which concerns not only people in Lancashire, but those across the north-west and in the rest of the United Kingdom, and, of course, most people in Bolton like to think that they are in Lancashire. I was grateful to the Minister for agreeing to see a delegation from the north-west, which included representatives from Bolton, on the first day of his appointment.

Mr. Elletson: Will the hon. Gentleman tell us what mandate he thinks he has to speak in the debate? He does not represent a seat in the Lancashire county council area, and he betrayed the electors of Bolton—who voted for a Conservative Member of Parliament. Why does not he resign now, fight a by-election, get a proper mandate and then come back to speak?

Mr. Thurnham: I will not have any lectures from the hon. Gentleman about my interest in the subjects that we are debating today. Those subjects are of concern not only to people in Lancashire, but to those across the north-west and in the rest of the nation.

Mr. Elletson: The hon. Gentleman is taking up our time.

Mr. Mans: The hon. Gentleman is not a Lancashire Member of Parliament.

Madam Deputy Speaker: Order. Each hon. Member is entitled to be heard with reasonable courtesy. I do not expect what almost amounts to barracking.

Mr. Thurnham: The Minister was good enough to see me on the first day of his appointment. I was grateful to him for doing that, because a delegation had travelled down from the north-west of England in the expectation of seeing his predecessor. I know that it was difficult for him, because he had had the brief for only a few hours, but the delegation was extremely grateful for the opportunity to see him. Various points were made at the meeting, and detailed letters were sent later, under my covering letter of 9 August 1996.
I shall not detain the House for too long with the points raised at the meeting. Representatives of Galebrook nursing home attended, representing the Bolton Association of Residential Care Homes, and raised several issues, including the difficulty of deciding whether people in need of care should be admitted to hospital if they had been admitted incorrectly.

Mr. Mans: On a point of order, Madam Deputy Speaker. I seek your guidance about the subject of the

debate. The Order Paper clearly states that the debate is about social services in Lancashire. The hon. Member for Bolton, North-East (Mr. Thurnham) is talking about a specific case outside Lancashire. Is that in order?

Madam Deputy Speaker: The hon. Member for Bolton, North-East (Mr. Thurnham) said that the point that he was making was relevant to the debate. I must listen a little longer to confirm that.

Mr. Thurnham: If Conservative Members were better informed, they would know that people from Lancashire go to Bolton association care homes. Therefore, the issues that I am raising are of as much concern to people in Lancashire as they are to people elsewhere in the United Kingdom. Such interventions show only Conservative Members' total ignorance of how the care system works. The concerns expressed by the Bolton Association of Residential Care Homes reflect as much on national issues of care as on the concerns expressed earlier in the debate.
Mr. Frank Hessey, from the Lancashire Association of Care Homes, made some points at the meeting, which he set out in a letter of 30 July 1996. I sent a copy of the letter to the Minister. I was a little disappointed to find that it took more than three months to receive a reply to the points raised at the meeting. I had always thought that the Minister was one of the more effective members of the Government, but the delay has shown the difficulty that he has had in mastering his brief. I hope that there will not be such delays in answering correspondence in the future. I also hope that there will be no excessive delays in issuing a White Paper on personal social services. We have been promised that such a White Paper will be published soon, and the newspapers have trailed it as being due in February.
Among the points raised by people from the north-west at the meeting was the need for rights of choice, and information about choice, for people entering care homes. There have been fears that people are not given the proper information, which they should have. I hope that, in the forthcoming White Paper, the Minister will make it perfectly clear that people who are in the process of entering a care home should be given every piece of information necessary for them to arrive at the best decision. We should start by providing proper choice for people going into residential care rather than their being given misleading information.
One of the aspects that is relevant to the debate is the number of judicial cases that have been taken up. The delegation that saw the Minister included representatives of South Lakeland Care Homes Association, who, at the time, had a judicial review pending. I ask the Minister to address the need to reform the law in that respect. It surely cannot be right, when there is so much pressure on care needs, that money is being spent on lawyers' fees in order to argue about the law.
I had a meeting yesterday with representatives of the Carers National Association, who feel that the law is in a mess. In view of pressures on the provision of care, it would be only right and proper for the Government to ensure that the law is properly understood. There should be a complete reform of community care law, so that all those concerned clearly understand it.
The Department of Health issued a press release on Friday about rising needs for community care, not only in Lancashire but elsewhere. It said that there was an 8 per cent. rise in the need for services.

Mr. Atkins: On a point of order, Mr. Deputy Speaker. Your predecessor ruled a moment ago on a similar point of order that was raised by my hon. Friend the Member for Wyre (Mr. Mans). This debate, about social services in Lancashire, is at the behest of my hon. Friend the Member for Blackpool, South (Mr. Hawkins). The debate is being widened well in excess of the subject that he raised and, as a result, other hon. Members who represent constituencies in Lancashire have been prevented from speaking. Will you rule on whether the hon. Member for Bolton, North-East (Mr. Thurnham) is exceeding the brief?

Mr. Deputy Speaker (Mr. Michael Morris): I have been in the Chair for precisely 60 seconds, and in that time the hon. Member for Bolton, North-East (Mr. Thurnham) has been entirely in order.

Mr. Thurnham: The hon. Member for Chorley (Mr. Dover) referred to the pressure on budgets, and to the effect on education budgets as well as social services. The press release issued by the Minister's Department showed that there has been an increase in the provision for home help and home care services of 8 per cent. There have been similar increases in the provision for day care services and other personal social services. Such pressure for the provision of extra services occurs not only in Lancashire but throughout the country.
I hope that next week's Budget will take proper account of the rising need because. no doubt, there will be pressure on education budgets if there is not sufficient funding for personal social services. Local authorities will be faced with difficult decisions about how to balance those requirements if the Budget as a whole does not provide extra funding.

Mr. Dover: Will the hon. Gentleman explain in his own words why there has been an underspend on social services in the county of Lancashire this year, as there was two years ago?

Mr. Thurnham: I have no doubt that it would be a coincidence if any authority spent to the penny its exact provision. In avoiding overspending, there is always a possibility of an underspend. What is clear is that there is a great pressure on the budgets generally, and if there is insufficient funding for social services, there will be pressure to reduce spending on education—even if members of all parties agree that education should be a priority.
I hope that the Minister paid full attention to the joint local authorities' submission, which said that an extra £665 million—or 8 per cent. of the total budget—was needed to fund personal social services in the coming year. If that money is not made available, obviously there will be pressure to reduce spending in other budgets at local authority level, just as the hon. Member for Chorley described a moment ago.
The Minister's reply to my letter, following my parliamentary question asking when I would receive a reply, did not address all the points raised at the meeting

to which I referred, or in the subsequent correspondence. I hope that he will be able to give full attention to the points that the delegation raised, especially those on cost shunting between health authorities and social services. The Bolton delegation felt that there should be an investigation—

Mr. Atkins: This is an abuse.

Mr. Thurnham: The issues that concern people in Bolton concern people not only in the north-west but in the country as a whole. Many people from Lancashire are in homes in Bolton and, no doubt, people from Bolton go to homes in Lancashire. It is absurd to say that people should not be allowed to go to a home of their choice. Bolton was, of course, in Lancashire for more than 800 years, and 99 per cent. of people in Bolton feel that it should be back in Lancashire. I should have thought that Conservative Members would welcome the prospect of Bolton being returned to Lancashire, as it should have remained in the first place.
The points that have been raised in correspondence with the Minister need a much fuller reply than he was able to give me in his brief letter of 18 November. I hope that he will be able to make further points in the debate, and that the White Paper that is due in February will not be delayed and will address the points very fully.

Mr. Colin Pickthall: Following the unnecessary and unwarranted speech of the hon. Member for Bolton, North-East (Mr. Thurnham), I do not have time to elaborate on any of the points that I wanted to make in this debate, which has clearly been called for many reasons, including the usual one of trying to get at Joan Humble, who happens to be the candidate for Blackpool, North.
I want to talk about the issue of overspend. The management letter from the district auditors to county councillors in April said:
prudence and accountability have been features of the financial arrangements in the County Council for many years. This tradition of excellence continues despite the challenge of present financial constraints.
It is true that, in 1993–94, 4.4 per cent. of the total net budget for social services in Lancashire was underspent and that in the following year, 0.13 per cent. of that budget was overspent. In 1995–96, 1.78 per cent. of that budget was again underspent. Although that is true, the reasons behind it are important.
The budget for Lancashire's social services in 1994–95 was drastically affected by the changes in the Government funding formula for community care, as no doubt the Minister will tell us. The estimated effect at the time was a reduction of £12.8 million for 1994–95. The county then expected a very significant overspend, and equally significant measures were taken by it to avoid that overspend and its knock-on consequences in subsequent years.
The effects of the process were painful and unpopular. It is true that there have been many complaints. Expenditure was squeezed in 1994–95 and 1995–96 and, at the same time, the effect in 1995–96 of the extended non-residential charging policy, which was brought in to counter the expected overspend, was being experienced.


The result was a £3.4 million underspend on a net budget of £48.4 million, about which the hon. Member for Blackpool, South (Mr. Hawkins) complained.
At present, the level of undercommitment is about £7 million, but the monthly increasing level of commitments for this financial year means that the treasurer expects that the spending target will be fulfilled by the end of the year. It is important to note in this debate that the underspend on independent sector purchases in 1993–94 was used to ease financial pressure on the same budget in 1994–95, and the same has been true of 1995–96, moving on to 1996–97.
Capping limits have necessitated budget reductions in social services of £19.4 million in the past five years. It is also important to note that Lancashire has exceeded the Government's figure of 85 per cent. of special transitional grant being spent in the independent sector in every year that that target has been in existence. The council also spends 8 per cent. more on social services than the figures calculated in its standard spending assessment.
I must sit down to allow time for the Front-Bench speeches. I suggest to the hon. Member for Blackpool, South that his next Adjournment debate should concentrate on analysing how the Government have managed to find the £4.4 billion that they did not know they had, and about which they were boasting in the press recently. Will he demand that they restore funding to the levels that existed before the cuts and extra charges imposed this year?

Ms Ann Coffey: I welcome the opportunity for a debate on community care, and the comments of those hon. Members who have raised issues relating to the implementation of care in the community, but I do not welcome the personal attacks on Joan Humble. The hon. Member for Blackpool, South (Mr. Hawkins) would be the first to complain if I criticised him in the Chamber without giving him an opportunity to respond. I hope that the Conservative election strategy will not involve using the Chamber to attack the Labour opponents of sitting Conservative Members.
I know that the hon. Member for Blackpool, South is off to the safer Surrey suburbs, leaving the hon. Member for Blackpool, North (Mr. Elletson) to struggle to hold his seat against our excellent candidate, Joan Humble. I do not know whether the hon. Member for Blackpool, South is aware that Surrey county council, where he is off to, wrote to all its private providers last year asking for free places because it had run out of money. I think that that happened at about the same time as he was castigating Lancashire county council for incompetent management of its budget. As he knows, several areas have community care problems.
My hon. Friends have dealt ably and thoughtfully with some of the specific criticisms on resourcing. As the Minister is aware, the problem for many authorities is dealing with issues of entitlement and choice for individuals within a limited budget, often with a fragmented system of health care in which resources are not being used strategically. The case that the hon. Member for Blackpool, South raised illustrates the challenges for local authorities in allocating resources for

individual family needs, taking its budgetary considerations into account. The appeal process considers those issues.
A number of cases have been taken to judicial review. That is unsatisfactory for all involved because they all have to hold their breath. Perhaps the National Health Service and Community Care Act 1990 could have been more thoughtfully framed. The consequence is that local authorities are attempting to deliver community care in the absence of guidelines. That is convenient for the Government, because they can blame everybody else, but it leads to unfairness, inequity and a deep sense of frustration for parents whose expectations have been raised. I sympathise with Mr. and Mrs. Gardner.
Conservative Members keep coming back to the issue of in-house services versus the independent sector. The public sector, the independent sector and the voluntary sector all have contributions to make to care in the community. It is unfortunate when they are put at each other's throats. I blame the Government for part of that problem. They seem to prefer to act in an atmosphere of competition and confrontation rather than in co-operation£the only framework within which matters can be resolved.
Conservative Members have said several times that they think that money could be saved by putting all the services in Lancashire into the independent sector, which is cheaper. They repeated that point today, but they also said that the primary considerations should be quality and choice. They cannot have it both ways, although they often try to. Last year, when Lancashire county council closed some of its homes£presumably in response to the pleas of Conservative Members that services should be shifted to the private sector£there was an immediate outcry from those same hon. Members. The hon. Member for Blackpool, South featured in the headline:
MP joins battle to save rest homes.
Calling for a delay to the closure of one home, the hon. Member for Fylde (Mr. Jack), said:
The most important reason for keeping the home open is the strong link it has with the local community.
The chairman of social services said, with great understatement:
It is not easy to close down homes.
It is certainly not easy, particularly when Conservative Members on the one hand demand that the council does so and on the other hand criticise it locally when it tries to.

Mr. Atkins: rose—

Ms Coffey: I shall not give way, because the right hon. Gentleman has taken up an inordinate amount of time in the debate. It is sad that our debate on community care is characterised by confrontation, conflict and confusion. That arises from the obsession of the Government and the Minister with what competition can deliver. We need to make changes that reward co-operation.
We support the objective of the 1990 Act: to give people genuine choice, particularly the choice to remain in their own homes. For that objective to become reality, there must be co-operation between the purchasing authorities and the range of providers. We believe that the private, voluntary and public sectors should be able to


make their important contributions. To blame Lancashire county council is to try to avoid responsibility for the legislation.
A local council cannot deliver the objectives of the Act by itself and nor can private providers or the health authority. Those objectives can be achieved only through partnership, particularly with carers, on whom we depend. They are the ones delivering community care. There are some excellent examples of good practice, showing what can be achieved by local authorities in spite of the obstacles that are put in their way.
The Minister should congratulate Lancashire county council and give it credit for some of the excellent things that it has done: for negotiating care agreements with four health authorities; for establishing joint planning with 12 NHS trusts; for establishing an intensive home care scheme, which facilitates early discharge from hospital and helps people to stay at home; for the provision of respite and short-term care; for the development of care homes to provide day care and outreach services; for the development of day care among independent sector providers; and for the joint development of dispersed housing schemes in the community.
Such initiatives are important for improving services and should be followed up across the country. There should be clearer guidance from the Department of Health on the approach to community care. Community care plans should be properly monitored by the social services inspectorate and by the NHS management executive. There should be better dissemination of information on cost-effective practices that deliver services in the most helpful way for those receiving them.
The research on social care outcomes recently commissioned by the Minister should have started in 1993. The present system of funding is obviously based on best bidders rather than best bids. I understand why. Without research on what the best bids are, it is difficult to decide which of the schemes put forward is best.

Mr. Mans: The hon. Lady has listed several ways in which matters could be improved. Does she agree that inspections for homes in the public sector should be the same as for those in the private sector?

Ms Coffey: Yes. The hon. Gentleman should have been aware that that is part of our policy.
People are sick and tired of the present situation. They are sick and tired of the chaos and failure of the community care scheme. They know that things will get better only when there is a Government prepared to lead. No amount of debates will convince the people of Lancashire that the Government are acting responsibly on community care. There is failure in services to children and in services to families. Resources are being wasted because they are not being used in the best possible way. The elderly, the sick and children are suffering. That is a reflection of a Government who do not care. If they cared, they would have got their act together on community care a long time ago.
I look forward to hearing the Minister's response. I hope that he does not simply bash Lancashire county council over the head, but will respond to the wider community care issues that it is facing.

The Parliamentary Under-Secretary of State for Health (Mr. Simon Burns): First, I must congratulate my hon. Friend the Member for Blackpool, South (Mr. Hawkins) on securing this important debate. I am delighted also to see my right hon. Friend the Member for South Ribble (Mr. Atkins) and my hon. Friends the Members for Blackpool, North (Mr. Elletson), for Wyre (Mr. Mans), for Chorley (Mr. Dover) and for Morecambe and Lunesdale (Sir M. Lennox-Boyd) present, as this is an important and sensitive subject.
The provision of community care is a vital function of local authorities. It offers help and an independent lifestyle, where possible, for the most frail and vulnerable members of society. Due to the vigilance and concerns of my hon. Friends in Lancashire, it seems that we now have to have an annual debate in the House on the failings of politically motivated county councillors in Lancashire and the provision of care in the county. It is a sad fact of life that old Labour is alive and well and running Lancashire county council—not new Labour for Lancashire, but neanderthal Labour.
At a time when all local authorities should be calmly and responsibly providing community care for the enhancement and improvement of the lives of those most in need, in Lancashire a highly politically motivated group of county councillors has hijacked all that is good about community care and turned it into a party-political football for the basest of motives. I remind those county councillors that the Government's policies for community care have helped many people in Lancashire—and throughout the country—to maintain an independent life and to receive better support in their own homes when faced with the problems brought about by disability or frailty in old age. Local authorities welcomed that policy and wanted the extra responsibility that it gave them. They must now accept responsibility for the decisions that they are making as they implement the policy. That includes Lancashire.
It might be helpful if I remind Labour county councillors in Lancashire of the words of Stanley Baldwin during the St. George's by-election in March 1931. He said:
Power without responsibility—the prerogative of the harlot throughout the ages.
It is time that councillors lived up to their responsibilities rather than parroted meaningless platitudes and slogans that do nothing to improve or enhance the quality or provision of community care. I shall explain some basic facts of life to them. The transfer of social security funding through the special transitional grant has resulted in substantial increases in the level of care to people in their own homes, in day services and in the use of care homes to provide the short breaks that are essential for many families. People entering residential or nursing care homes have benefited from the assessment process to identify their needs and match them to a care home of their choice.
The funding arrangements that we have put in place have also resulted in substantial growth of independent sector providers, real progress towards a mixed economy of care, and better value for taxpayers' money. Those are considerable achievements, both in Lancashire and elsewhere, but I have been concerned that the


implementation of the Government's reforms has not been as smooth and effective in some areas as we would have wished.
Several of my hon. Friends have today raised matters of serious concern about what has been going on in Lancashire. They also did so last year in a debate initiated by my hon. Friend the Member for Blackpool, North. Those concerns were reiterated today by my right hon. Friend the Member for South Ribble and by my hon. Friends the Members for Blackpool, South and for Wyre. They expressed concern about financial mismanagement and bureaucracy resulting in sudden cuts in services and other problems that Lancashire has not been able to deal with as it should.

Mr. Mans: Will my hon. Friend give way?

Mr. Burns: I am sorry, but I do not have time.
My hon. Friend the Member for Blackpool, South mentioned the sad case of David Gardner. I am concerned about that case. I understand that Mr. and Mrs. Gardner's complaint about lack of continuity of care has been upheld, but that Lancashire county council has not yet said what it intends to do as a result. I hope that it will learn from the lessons, problems and stress that the Gardner family had to go through to get to this point. I shall ask my officials to obtain further information about the case and respond in writing to my hon. Friend once we know more from the social services inspectorate about what has been going on.
As a result of the problems highlighted in the debate last year, my predecessor was sufficiently concerned to ask the chief inspector of the SSI to provide a full report on Lancashire. That document confirmed that there was cause for concern about how Lancashire was implementing policy in several respects. Subsequently, the chairman of the social services committee, Mrs. Joan Humble, received our analysis of the problems and was asked to respond with an action plan. Our analysis raised serious issues, which required a considered and constructive response. Mrs. Humble's initial reply did not demonstrate such a response. After time for further and, thankfully, more mature reflection, however, a plan was duly received from Lancashire in September. I have asked the chief inspector of the SSI to monitor and report back to me on the implementation of that plan.
I am concerned to emphasise to Lancashire county council that decisions about the allocation of services should be taken and applied consistently, and with sensitivity to the needs and feelings of service users. The council has responded with assurances that disruptions in the continuity of care, which occurred in earlier years, have now been dealt with and that more effective monitoring arrangements are in place. I hope that that is indeed the case, and I shall be looking for evidence of that when Lancashire's action plan is reviewed.
I am also concerned that changes to the balance of services should avoid unnecessary disruption to service providers. The council has responded with an intention to publish its purchasing policies in a form that will be more readily accessible to service users and providers. Good communication among commissioners, providers and users of services is essential to effective management of

local change, and it is particularly important that providers are clear about the intentions of the council in determining its requirements for the future and clarifying how it will use its growing resources to meet those ends and needs.
The funding of community care has featured heavily in this debate, particularly in the comments of the hon. Member for Burnley (Mr. Pike). Total personal social services funding by the Government is a massive £9 billion including the social security contribution. That is a phenomenal amount of money compared with what was being spent in 1990.
I have also heard a great deal of protest from the county council about its inability to manage community care without even more money. When I look at the figures, however, I see an interesting picture. Within the total amount that the Government consider the county council needs to spend this year to provide a reasonable level of service is an element of £156 million for community care, which includes £61 million for its new responsibilities and the community care reforms. That represents an increase in total resources for community care since 1990–91 of 104 per cent. in real terms—over and above the rate of inflation. That means that Lancashire has done even better than the national average, which was a doubling of resources in real terms during that period.
It is for each local authority to set its budget, but given the accusations made by Lancashire, I find it surprising that it underspent in two financial years. It was clear that the hon. Member for Burnley was unable to explain that and the so-called justification offered by the hon. Member for West Lancashire (Mr. Pickthall) made me remain deeply sceptical of the line that he was trying to push.
Given the length of time that I have to reply, I shall not be able to cover all the points that I was prepared to cover. What I will say is that Lancashire is a concern. The SSI has looked into Lancashire. A plan has been drawn up, and it will be monitored with vigour because, as my hon. Friends have so rightly identified in the debate, it is crucial that people in Lancashire are given the best, most satisfactory and most effective care without the worries and disruption that, sadly, they have had to put up with all too often. It is crucial that Lancashire establishes a good rapport and working relationship with the private sector, which plays such an important role in providing help and care for those who need it.
My hon. Friends and others have raised interesting and useful points about how things are going in Lancashire. As I have said, I shall ask the SSI to monitor the situation there closely. In particular, I shall ask the chief inspector to seek further explanation from the council of its financial management and to consider whether further action by central Government is necessary. I do not take that decision lightly, but because of the excessively long-running problems that I have highlighted, it is the least that I can do to ensure that there is better provision of care.

Mr. Deputy Speaker: Order. I want to place it on record, for the guidance of hon. Members, that these are Back-Bench debates and that both Front Benches should recognise that the wind-up should not be longer than 20 minutes.

Waste Recycling (Scotland)

Mr. Archy Kirkwood: I am grateful for the opportunity to have a short debate about an important subject. As an Opposition Member, I spend most of my time denouncing Government policy as rubbish, so it is a pleasant change to discuss proposals on rubbish. We can make jokes about it—we shall no doubt hear many puns and bons mots, because I know that the Minister has a reputation for a scintillating sense of humour—but it is a matter of some importance and concern.
The concern is not about the Government's stated strategy and objectives—since the introduction of the Environmental Protection Act 1990, everyone recognises that they have been on the right track in trying to give a lead in promoting recycling—but events, admittedly largely unforeseen ones, have combined to render less effective, to put it mildly, some of the efforts made in good faith by Scottish local authorities.
Unless we get a clearer idea of the Government's long-term strategy, some local authorities in Scotland might withdraw from recycling altogether, and that would be a shame. I want to persuade the Government to consider their long-term strategy, and I hope that that will reassure people that their efforts will not be in vain, but will be supported as much as possible by central Government.
The history of recycling in my local authority, which is now Scottish Borders council, is instructive, and other authorities in Scotland will have similar stories. In the old local authority set-up, which came into effect in 1975, the four district councils in the Borders—Tweeddale, Ettrick and Lauderdale, Roxburgh and Berwickshire—undertook a series of independent and separate recycling projects according to their respective priorities and needs.
After the introduction of the Environmental Protection Act 1990 and the Scottish Office's 1991 guidance on recycling, the councils were issued, as waste collection authorities, with a requirement to produce a recycling plan, which had the aim of recycling 25 per cent. of household waste by 2000, and everyone supported that as an objective; at the time, we were recycling only about 2 per cent. of household waste, and everyone recognised that we had to improve on that.
The former district councils, as waste collection authorities, did their best through 1991, 1993 and 1995 to co-ordinate among themselves within the resources available and to agree a strategy for the Borders. They secured useful assistance from the local enterprise company, which produced consultants' reports to inform the process, but they were constrained until 1995 by the fact that, for lack of resources, they could not integrate their services.
In the financial year 1995, the four authorities met again to consider the commissioning of a feasibility study into converting as a recycling centre a building that one of them had recently purchased. Each of the constituent authorities, and the local enterprise company, contributed towards another consultants' report. On 1 April 1996, under the reorganisation into unitary authorities, the four district councils were amalgamated with the former Borders regional council to form the Scottish Borders council.
In May 1996, the council took up the previous authorities' commitment to recycling, committing £200,000 from its capital budget and £100,000 from current revenue. Almost simultaneously with that ambitious and proper act, with which everyone was pleased—the sums added up, and the proposal made a lot of sense as an attempt to reach the target set by central Government—the paper merchants with whom the council dealt intimated that the price for mixed paper would drop from £35 to £3 a tonne.
In October 1995, the council had been receiving £82 a tonne for mixed paper; the wild fluctuations in market prices were certainly beyond the control of the local authorities. The council's financial estimates for the recycling centre project had been based on what was then considered the conservative figure of £30 a tonne. As if it was not bad enough having the bottom fall out of the market, the merchants then introduced a quota, and would purchase only 85 per cent. of the council's raw material. That immediately produced a glut of recovered material, and a huge backlog began to build up at depots in Galashiels and Hawick, which was another problem for the council.
In September 1996, the council reviewed its strategy, and committed additional resources in the form of extra manpower to separate cardboard from the mixed paper so that it could get a better price. That had a significant impact on the estimated total loss that the council faced, and still faces, of between £75,000 and £100,000 a year-a significant part of the council's cleansing services budget.
To make matters worse, in November 1996, the council was advised by the waste paper merchants that the price for card had reduced from £23 to £20 a tonne; worse still, the price for mixed paper had gone from £3 a tonne to nil: there was no value at all in the mixed paper that the council had collected for recycling.
It became clear at that stage that neighbouring authorities were experiencing similar problems. The local authorities all found that they had to pay the merchants to take the paper off their hands, because otherwise they would have had to use landfill sites to dispose of the paper, and pay £7 a tonne under the landfill tax. I know that Scottish Borders council and other local authorities will have written to the Scottish Office to highlight the problem and outline the difficulties that they may face in the future.
The councils are co-ordinating some activity through the Convention of Scottish Local Authorities. A catalogue of unexpected financial blows caused by the collapse of the market has hit Scottish Borders council. It is also worried that not only local authorities but all commerce and industry has been taking account of the introduction of the landfill tax.
I entirely support the principle of the landfill tax, and understand what the Government are seeking to do. It makes much sense in principle. However, the draft EC directive on packaging waste, which requires producers, packagers and retailers to examine their operations and recycle packaging material, is compounding the glut of material on the market and leading to even lower prices. That explains the low prices that are being received for recovered goods. The draft directive came on stream only on 1 October, and aims for about 50 per cent. recycled packaging. That will have a major impact and make matters worse.
In recent months, Scottish Borders council and its sister authorities have been examining all sorts of alternative markets for recovered materials and for ways out of the mess. Few options are available. Like my next-door neighbour, my right hon. Friend the Member for Tweeddale, Ettrick and Lauderdale (Sir D. Steel), I have always encouraged the council to go down the route that it has taken. It has always, rightly, had a high profile on environmental issues. Bluntly, unless central Government can do something, it may have to reconsider its environmental policy, which would be a shame.
I conclude with a few suggestions, some of which will be harder than others for central Government to consider. First, we must consider diverting some of the £280,000 that will be payable by Scottish Borders council in a full financial year in landfill tax to help with recycling and the sale of products to the market. Secondly, the Scottish Office should consider introducing a grant system whereby local authorities that meet their Scottish Office targets will receive funding to improve continually on those targets.
Thirdly, the Scottish Office could step in to set an intervention price for recovered materials. I know that that would be difficult, but it is essential that someone should co-ordinate the financial planning and get some order into the process of estimating what this policy and associated actions will cost local authorities. Fourthly, the Scottish Office should consider top-slicing and ring-fencing part of the council's capital allocation for environmental projects. That would allow each local authority to set its own priorities and targets within an allocated budget.
Fifthly, the Scottish Environment Protection Agency must quickly produce a waste strategy. I realise that it has existed only since the beginning of April, but it has been charged with producing a waste strategy. That should include recycling and waste minimisation, with realistic targets for recovering materials for recycling.
Sixthly, any target set by the Scottish Office, or any of its agencies such as SEPA, should be accompanied by the appropriate finance to enable local authorities to meet them. Finally, the Government, in the longer term and in the broadest sense—it cannot be done by the Scottish Office alone—should think about setting minimum targets for the recycled content of goods for sale, which could create a sensible long-term market for recovered products for recycling.
My local authority's experience, which is not unique, shows that, unless a more stable market is established in the supply of recovered materials to recyclers in Scotland, the Government's environmental strategy, with which I agree, will fail to achieve its desired results. The whole policy may founder on the need to implement emergency solutions. That is what Scottish Borders council faces. It is having to take drastic action and do things that it does not think are in the long-term interests of Borders council tax payers, or of the environment. It pleads with central Government to recognise its position, set up a long-term strategy, and come to its aid.

The Parliamentary Under-Secretary of State for Scotland (Mr. George Kynoch): I congratulate the hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood)

on securing this important debate. I know that he does not regard the matter as a waste of time. That will be the full extent of my humour in this debate. I will not compete with the usual rubbish that comes from the hon. Gentleman. However, I appreciate the opportunity of dealing with the important subject of recycling targets for Scottish local authorities.
Recycling is part of the much wider issue of waste management generally. It might be helpful if I begin by setting out in broad terms the Government's policy on recycling and on waste management as a whole.
The Government recognise the importance of the waste management industry. Commercial, industrial and household waste account for around a quarter of the annual total of waste. We are especially aware of the scope to add value to much of the waste handled. The principal vehicles through which value can be added are re-use and recycling. We are therefore especially keen to encourage an approach to waste management that seeks opportunities to treat waste as a potentially valuable resource.
The Government subscribe to the idea of a broad waste management hierarchy. The options in such a hierarchy are reduction, re-use, recycling and recovery, and disposal. I wish to deal with the recycling and recovery option, which includes composting elements of the waste stream to make a usable product, and energy recovery from waste. In general, however, recycling is considered to be the recycling of specific materials. To be effective, it requires the active involvement of a wide range of parties, such as individual citizens, voluntary organisations, local authorities and industry.
The role of local authorities in the recycling process is the main focus of this debate. The hon. Gentleman mentioned that, in the 1990 White Paper on the environment, the Government set a target of recycling half of all household waste that can be recycled by 2000. It is estimated that that broadly equates to a target of 25 per cent. of all household waste.
In parallel, the Environmental Protection Act 1990 introduced a range of measures designed to create a more favourable climate for recycling. It introduced a scheme of recycling credits, and placed a requirement on all waste collection authorities to produce waste recycling plans. It also required waste disposal authorities to have regard to the desirability of including terms and conditions to maximise recycling in their waste disposal contracts.
The Government have also introduced the landfill tax—I am pleased that the hon. Gentleman welcomed that. It is the first stand-alone environmental tax to be introduced in the United Kingdom. It applies the "polluter pays" principle, and will promote a more sustainable approach to waste management. It will give waste producers a powerful incentive to cut the amount of waste that they send to landfill.
That has already led to the setting up of materials recovery facilities in Scotland where waste items that may be used in recycling are extracted from the waste recovered before it is sent to landfill. Another advantage is that we will be using income from the tax to reduce employers' national insurance contributions, thereby shifting taxation from jobs to pollution. I hope that that addresses one of the hon. Gentleman's points on using the funds received from the landfill tax.


The Government's policy on recycling is influenced by activity in the European Commission. The Commission proposes legislation on other measures designed to achieve recycling and recovery; the directive on packaging is an example. The Commission also influences recycling through its network of priority waste stream groups. The UK Government participate in those groups and seek to ensure that their outputs are consistent with Government policy.
The hon. Gentleman referred to the recycling targets, particularly in the context of local authorities and household waste. The Government's approach is to set challenging, but realistic, targets. For household waste, we have set a target of recycling half the recyclable element of all waste by the year 2000. That target equates broadly to a target of 25 per cent. of all household waste. As a general target, it is not binding on individual authorities.
We recognise that recycling is achieved more readily in some areas than in others—for example, because of geographical factors and population density. While authorities should set themselves a target of recycling 25 per cent. of all household waste, in practice those unable to achieve that target will be bolstered by those that are highly successful and surpass it.
Concerns have been expressed on behalf of Borders regional council, not only by the hon. Gentleman today, but by the council, in correspondence with the Scottish Office. As the hon. Gentleman said, other councils share those concerns. The particular problem appears to have arisen from the slump in demand for waste paper and the effect that that has had on prices. Borders council has estimated that, as a result, its income level could drop by up to £100,000 in the current year. That is also likely to be combined with a need to dispose of the surplus material collected to landfill.
It has therefore been suggested that the Government should set an intervention price for recycled materials, to encourage and support local authorities in achieving recycling targets and to defray costs. While I can understand the nature of the problems faced, I do not think that the Government should intervene to stabilise prices.
Recycling on a national, European and global scale should be allowed to stabilise through self-regulation. Intervention in the past—through the German packaging ordinance—caused significant problems in the market, and resulted in a flood of material being collected well beyond the capacity of the existing recycling plant. That pushed down the prices paid for such material throughout Europe, and I do not believe that we should seek to establish an intervention price mechanism.
It has also been suggested that the Customs and Excise should consider a short-term exemption from landfill tax for paper wastes that are required to be landfilled as a result of the market's inability to accept the material from suppliers. There are already some exemptions from that tax, but they generally reflect the fact that the material involved is not suitable for recycling. Those exemptions include waste dredged from ports, and the burial of domestic pets at pet cemeteries. Paper products, however, are eminently recyclable, and it is not sensible or appropriate to offer the exemptions sought. Were waste paper material not specifically separated from the waste stream, it would naturally be disposed of through landfill.
It has also been suggested that an investigation should be undertaken into the existing market for recyclable paper waste to establish whether and when material will continue to be required from suppliers such as local authorities. The demand for waste paper is a derived demand, as it is largely dependent on the demand for the final product. It is not uncommon for supply to exceed demand, and for prices to decline.
It is not for the Government to undertake the sort of investigation suggested. The implementation of the European Community's packaging directive will lead to a recovery of the recycled paper and cardboard market. In Britain, its implementation, through the producer responsibility for packaging waste scheme, is likely to have the longer-term effect of forcing a growth in recovery. The continuing high price of virgin pulp should also facilitate the recovery of the recycled product.
A further reason for optimism is the likely future demand for recycled paper from the far east. There is also potential for growth in the United Kingdom paper manufacturing capacity if the products are competitive. All those factors lead me to the conclusion that markets for recycled waste paper will become viable.
The hon. Gentleman raised two points involving the treatment of expenditure on recycling in the context of the overall local government finance framework. First, he suggested that spending on environmental projects might be ring-fenced. Secondly, he asked whether extra grant could be made available to authorities for the collection of waste for recycling. Both those points boil down either to an increase in public expenditure or to a reduction in local authority discretion.
It would in principle be possible to separate recycling expenditure from all other local authority expenditure, and it would be possible to introduce a specific grant scheme for such expenditure. However, if one or both of those courses were adopted without affecting existing local authority expenditure provision, that would be a straightforward addition to public expenditure. The hon. Gentleman knows only too well the overriding importance of keeping that expenditure under control.
Alternatively, the proposals could be implemented within existing expenditure provision. That would, however, reduce the expenditure provision and grant available for general distribution to authorities. The Convention of Scottish Local Authorities is opposed to the introduction of new specific grants, because the process fetters local authorities' discretion in using the provision available to them. The Government are concerned that specific grant schemes introduce administrative costs, not only for the Government, but for local authorities. Those schemes use up resources that are better spent on service provision.
Having listed general points of principle, I must also ask the hon. Gentleman what other candidates he has in mind. Local authorities provide many valuable services to the community and there are many other cases where an argument could be made for some special treatment. At the end of that road lies a highly controlled and expensive centrally directed grant and expenditure system, in which much of the discretion would lie with central Government rather than local authorities.
Perhaps the hon. Gentleman believes that that should happen, which is why he makes his devolution proposals for a central tax-raising parliament in Edinburgh that would dominate local authorities and take away many of their decision-making powers.

Mr. Kirkwood: Rubbish.

Mr. Kynoch: The hon. Gentleman shouts, "Rubbish," continuing in the same spirit as he began the debate. But he advocates such a proposal, which would waste valuable resources. It would set up an unnecessary extra layer of bureaucracy, which would not help to solve the problem.
The hon. Gentleman also mentioned the Scottish Environment Protection Agency, which is drawing up a waste management strategy for Scotland. He asked when that would be available, and was honest enough to recognise that it is a new organisation, with many tasks. Clearly, an important element of its strategy will be recycling. That strategy is currently being prepared, and I accept the hon. Gentleman's call for it to be drawn up as quickly as possible—it will clearly be important.
Recycling needs to be seen in its wider context. The choice of the most appropriate waste management option must depend, to some degree, on the local circumstances that determine both the environmental and economic advantages and disadvantages of each option. To be credible in that context, recycling must be seen to be sustainable in both environmental and economic terms. However, the Government firmly believe that recycling must play an increasingly prominent part in the United Kingdom's waste management strategy.
The hon. Gentleman highlighted the difficulties faced by Borders council. I know that the same problems are being faced by many other councils. He talked about the variation of price over the past years. Current prices for waste paper are very low.

Mr. Kirkwood: They cannot go much lower.

Mr. Kynoch: The hon. Gentleman is right. He talked about the prices a year or so ago—about one year ago, the price was about £100 per tonne, and in the past four to five years there have been major fluctuations in price. I believe that the market will return and prices will increase. I urge the council not to make hasty decisions that might undo some of the significant good that it is clearly trying to do in its waste strategy. I trust that it will look at the medium to longer-term prospects in the marketplace and continue to develop its proposals, with a view to ensuring that it is in a good position to take advantage of higher market prices when they return.
I thank the hon. Gentleman again for raising this subject today. I know that it is an important issue, which is recognised by councils throughout Scotland. I see that the hon. Member for Moray (Mrs. Ewing) is present, and I am sure that she, too, appreciates these problems. I believe that the Government's policy in respect of recycling and environmental control is absolutely right, and I welcome the fact that the hon. Member for Roxburgh and Berwickshire recognised that in his speech today.

Brewing Industry

1 pm

Sir Ivan Lawrence: This debate has almost become an annual event, thanks to the kindness of a succession of Speakers and Deputy Speakers. Although I have struck out—as our transatlantic cousins would say—on two previous annual Adjournment debates in which I raised the subject of the brewing industry in general and my brewing constituency of Burton in particular, I hope to score a sensational home run this time.
Much has been happening recently in the field of brewing, especially in Burton on Trent, where we have the finest breweries, in which Bass, Carlsberg-Tetley and Marston's manufacture their products and maintain the great Burton brewing tradition. Brewery workers, shareholders and, above all, the public are delighted that we have all-day opening and now Sunday afternoon opening as a result of the Government's sensible stripping away of overregulation.
The industry—whether manufacturing, retail, leisure or management—will now have the opportunity of attracting a new generation of young workers because we have lowered the age limit for working in bars, under proper supervision and with the obligation of further training. We welcome the lifting of restrictions and the reduction in tax on amusement machine prizes in pubs, which has resulted in the amusement machine industry in Burton being able to save itself and start to flourish once again.
Children certificates, although a good idea, have sadly attracted a low take-up of about only 3 per cent. That is largely due to regional inconsistencies between licensing boards. Some boards impose conditions—such as requiring nappy-changing facilities or low bar stools to avoid accidents—that are prohibitive and increase costs and so are not worth implementing, which is a shame.
Little beyond consultation has taken place in respect of the extra hour's opening on Friday or Saturday evenings, which might do more to defuse potential trouble from gangs of youths in town centres. The Bill on the stocks to limit under-age drinking in public places will be widely welcomed. Perhaps what we really need is a new, all-embracing licensing statute—the last one is now 32 years old and my commentary on it, which was written for Current Law in 1964, is that much out of date.
I turn now to the issue of the tied house—the partnership between brewer and publican whereby the publican can enter the brewing industry with only limited resources but can still flourish, in return for a commitment to sell a particular brewer's beers. Of course, that partnership, which could be exploitative, has been modified over the years to ensure that it is not, by giving the publican the rights to buy beer brands from other brewers, to choose his own supplier of wines, spirits and soft drinks, and to be protected by landlord and tenant legislation.
Some argue that the tie could restrict competition and keep beer prices high, as indeed it might; but the better view is that the abolition of the tie would be more likely to lead to the closure of many regional and smaller brewers, the increased domination of the market by fewer national brewers, higher prices and lower employment. Happily, the Government have adopted that view and my hon. Friend the Economic Secretary might want to reaffirm that today. Certainly, the industry welcomes the support from the Government in upholding the tie.
That support is especially welcome as the European Commission has shown an inclination to challenge the continuance of the exemption that we enjoy for the tie when it expires at the end of 1997. The Commission is challenging our arrangements for guest beers on the ground that our requirement that such beers should be cask conditioned discriminates against Euro-beers. That is, of course, complete nonsense because only 10 per cent. of British pubs have to have guest beers at all and we import properly £230 million-worth of Euro-beers a year, which is more than any other European country imports.
We have the most open beer market in Europe. If only it were possible to see British beers on sale in German pubs in the same way as German beers are sold in British pubs, we should all be thankful. The brewing industry welcomes the Government's robust defence in Europe of British brewing and British pubs. The British people have absolutely no wish to be pushed around by Brussels in the important matter of British beer.
The biggest problem affecting the industry today, as it has been whenever I have raised the issue over the past three or four years, is the level of beer duty. For that reason, I am delighted to see that my delightful hon. Friend the Economic Secretary will be answering the debate. The root of the problem is that we pay 30.7p per pint in duty on our beer, whereas the French pay 4.4p per pint—we pay over seven times as much. To a lesser extent, that gap exists in relation to all other European countries. Our beer duty is much greater than that of most other countries in Europe.
I concentrate on our trade with France because, France being nearer to us than other European countries, that is where most of the imports to this country come from. As a result of the differential in excise duty, imports from France have risen over the past three years from 400,000 pints to 1.1 million pints a day. That represents 4.5 per cent. of the United Kingdom beer market and £700 million a year in beer sales in British pubs, which is more than the sales of any UK regional brewer.
As a result of the price differential, a third of French beer is carried across the channel in hired vans and much is sold illegally at car-boot sales on council housing estates or door to door. The van trade in smuggled beer costs every pub in the country over £3,000 a year in lost beer sales and the Exchequer loses £250 million which, of course, the taxpayer has to make up. The number of vans crossing the channel by ferry, never mind those coming under the channel—such crossings have, sadly, temporarily stopped, but we did not know how many vans were involved anyway—is more than 64,000 a year, which is 175 a day. Each van of smuggled beer contains 1,500 pints, which is more than the weekly trade of a small community pub.
Surveillance by the Brewers and Licensed Retailers Association—which I still prefer to call "the brewers' society"—has identified vans from Dundee, Aberdeen, Truro, Bangor and Northern Ireland, so it is not only a London and south-east England trade.
Another aspect that should worry my right hon. and learned Friend the Chancellor and my hon. Friend the Economic Secretary, as well as the Chancellor's Euro-partners, is the fact that in 1994, Customs and Excise recorded UK beer exports to France of 57 million pints, but French customs recorded only 26 million pints entering France from the UK. Thirty-one million pints

appear to have got lost. How? The likely explanation is that those exports existed only on paper. Why? To allow UK beer duty to be reclaimed as pretend sales to France. Those pretend exports are diverted to the UK market, and sold at full retail price as though UK duty and VAT has been paid on them. In that way, fraudsters make about £30 million a year. If the duty differential did not exist, those fraudsters would have to seek another way to cheat the Revenue.
What is the practical effect of that tax differential? My answer is that, as about 60 per cent. of cross-channel beer purchases replace what would otherwise be sold in British pubs and off-licences, about 10,000 pubs are likely to close in the next five years, and as a result 90,000 jobs will be lost in the UK in pubs, breweries and suppliers.
The Government must want to do something about that. What should they do? The industry's answer is to reduce excise duty to a level that removes the incentive for cross-border shopping and bootlegging. The reduction could be phased over five years, to reduce the rate to about 6.5p per pint by the year 2000. That would be a really good way to celebrate the millennium.
My right hon. and learned Friend the Chancellor could start with a cut of 4p in next week's Budget, so this debate is timely. That is why I am grateful to you, Mr. Deputy Speaker, and to the Speaker's Office for allowing me to initiate it, so that I can affect the intentions of the Chancellor in the Budget in a few days' time.
The Treasury will argue, as it always does, that cutting beer duty would reduce tax revenues, which would mean that £2 billion had to be found elsewhere, or that the public sector borrowing requirement had to be raised at a time when it needed to be reduced to make way for tax cuts. But I wonder what assessment the Treasury has actually made of the benefits of reducing tax.
Would not such a reduction inevitably lead to lower retail prices, therefore to more beer sales, and therefore to more tax revenue to offset part of the loss? Would it not inevitably boost jobs in pubs, breweries and related industries and generate higher profits and tax returns? Would it not inevitably lower the retail prices index and therefore pay settlements? Would not those factors prolong the fall of inflation, which the Government have achieved to their great credit, increase competitiveness, another of their achievements, increase economic growth, yet another of their successes, and produce a higher tax yield?
If my hon. Friend the Economic Secretary is unsure about that, I must report that Oxford Economic Forecasting, using the Treasury's economic model, can demonstrate that 6p off the duty on a pint of beer would have just those effects and would reduce inflation by 0.2 per cent. That organisation says that official estimates substantially overstate the true first-year cost of cutting beer duty, which would actually reduce the public sector borrowing requirement in its second year.
I have heard it said that such a reduction would only lead brewers to maintain the high beer price, but prices in UK pubs are already considerably cheaper than those in the bars of Europe. The wholesale price of beer in Britain has fallen by 10 per cent. in real terms in the past three years and 75 brewing and pub company members of the Brewers and Licensed Retailers Association have promised to pass on fully any reduction in beer duty in the coming Budget.
Our brewing industry is one of the oldest and best of British industries. Directly and indirectly, it employs 750,000 people, even now. Our pubs are the finest in the world, although their number is steadily decreasing. Beer is the most popular alcoholic drink in Britain today, and we consume a fifth of the European Union total, spending more than £13 billion a year and raising more than £4.5 billion for the Treasury—a substantial proportion of which is raised in Burton upon Trent. That is the equivalent of 3p off income tax.
Brewing is a national institution, and my constituency is at its heart. For, as the great poet A. E. Housman wrote:

"Say for what were hop-yards meant,
Or why was Burton built on Trent'?
Oh many a peer of England brews
Livelier liquor than the Muse,
And malt does more than Milton can
To justify God's ways to man."

We in Burton, we in the brewing industry in the country, ask for relief from unfair taxation. Is it really too much to ask?

The Economic Secretary to the Treasury (Mrs. Angela Knight): I congratulate my hon. and learned Friend the Member for Burton (Sir I. Lawrence) on being granted this debate—his annual Adjournment debate on a subject dear to his heart and to the heart of many Members of Parliament and many people in the country.
I have a sad confession to make. I am a cider drinker, not a beer drinker. I hope that that at least puts me in the category of the alcohol consumer, even if I do not consume the product that is brewed in my hon. and learned Friend's constituency.

Sir Ivan Lawrence: May I invite my hon. Friend to come to Burton-on-Trent soon and frequently, so that I may introduce her to the joys of Burton beer?

Mrs. Knight: My hon. and learned Friend has already tried to introduce me to the charms of Burton beer, not altogether successfully, but I will visit his constituency with pleasure. I believe it is well known that, when one is at least a quarter of an hour out of Burton on the A38, it is possible to smell the hops through the car windows, and that smell is a very tempting prospect.
The Government acknowledge the importance of the brewing industry. The industry contributes significantly to Government revenues, is a wealth creator in the economy generally and plays a socially cohesive role in pubs throughout the country. It is a considerable employer, directly and indirectly. As my hon. and learned Friend's contribution developed, I understood why the debate was timely.
No right hon. or hon. Member would expect me to divulge the Chancellor's Budget intentions—there are a few more days to wait—but I can say that the worries that my hon. and learned Friend expressed about the impact on brewers of cross-border shopping and smuggling are a

very significant factor, which the Chancellor will take into account in reaching his decisions. He has done so for the past few years, and I know that he will do so again.

Mr. William Ross: May we be assured that the effects of the smuggling of tobacco will also be taken into account?

Mrs. Knight: I can give the hon. Gentleman that assurance. My right hon. and learned Friend will take into account all matters relating to cross-border smuggling when he reaches his decisions.
My hon. and learned Friend clearly set out some of the general aspects relating to the brewing industry in his opening remarks. In so doing he recognised the many recent changes to that industry. Community pubs are popular, but there have unfortunately been closures in some areas—for a number of reasons. The off-licence trade has, over the years, taken business away from the pubs, and in the off-sales sector supermarkets have increased trade at the expense of off-licence shops. Social trends and changes in drinking patterns have also played their part.
Over the past 30 years or so the main drink of practically every country in Europe has declined as a proportion of the whole: beer is down in beer-drinking countries and wine is down in wine-drinking countries. The industry has responded to these changes in consumption. At retail level, it has reassessed the pub structure to help it compete more successfully. We now have a variety of types of pub catering for particular groups—targeting a high-spending young clientele with theme bars, Irish bars and so on. Then there are community or country pubs, which have generally been made more attractive to customers by renovation and improved facilities—including the idea of the family pub catering for children.
I hear what my hon. and learned Friend says about the concerns regarding regional inconsistencies as between children's licences; we shall take a careful look at that.
I think that the family pub is an excellent idea. It means that I can take my children into the pub with me and they do not have to go through what I went through. My father used to leave me in the car in the car park with a fizzy orange drink which I did not like and, occasionally, a packet of crisps, while he stayed in the pub for what seemed like hours. I am sure that it was not really that long, but certainly, being able to take one's children into pubs leads to a more family-like atmosphere and is a great benefit. I note that my hon. Friend the Member for East Surrey (Mr. Ainsworth), the Government Whip, is nodding in agreement. He too has children who can benefit from these changes.
More people now drink at home because of drink-driving laws and because of home entertainments, but also because of significantly cheaper drinks being available in supermarkets. It is important to recognise and to cater for these long-term trends.
My hon. and learned Friend mentioned his concern about the guest beer provision. Even though I am not a beer drinker, I am well aware of the concerns that many have expressed on this matter. Indeed, the organisation CAMRA has brought it to many people's attention. The European Commission alleges that cask-conditioned beer is not produced in any significant quantity in other


member states, so the provision infringes article 30 of the treaty of Rome by discriminating against beer producers in other member states. The Government dispute that view.
To resolve the issue, on 11 October officials of the Department of Trade and Industry and of the Ministry of Agriculture, Fisheries and Food met Commission officials responsible for the free movement of goods in the single market, and representatives of the CBMC—the European brewers federation. They met to clarify the facts behind the dispute. It has been agreed that the CBMC will provide information on the extent of cask-conditioned beer production in other member states. I can assure my hon. and learned Friend that the United Kingdom is committed to resolving the issue. We do not believe that the guest beer provision breaches article 30 of the treaty.
Cross-border shopping affects not just the brewers; all involved in the production, distribution and retailing of alcoholic drinks are affected. On the other hand, the single market has brought a great number of benefits to UK business generally, to the extent that I notice that some brewers are reporting healthy sales on the continent.
Tax-induced cross-border shopping has clearly had an effect on the brewing industry, but since 1993 UK beer production has continued to increase, and most major and regional brewers report increased profits.
The drinks industry is working closely with Customs and Excise. It has been doing so for some time, first to agree the amount of personal imports of alcoholic drinks, and secondly to look at cross-border issues. The calculation that has been agreed is that in 1994 between 3 and 5 per cent. of the UK market was affected by the importation of alcoholic drinks. There is also general agreement on the overall amount of legitimate importation and smuggling. Agreement is still to be reached on how much of what is purchased cheaply abroad is in substitution for what would be bought here, and how much is additional consumption.
I can assure the House that we are not complacent. It is, however, important to keep the cross-border issue in proportion. Customs' own estimates of revenue lost—in duty and VAT—for legitimate cross-border shopping last year put the figure at £210 million for all alcoholic drinks. The share attributable to beer was £40 million. That assumes that half the trade is additional; but even if none of it was additional, the figures would not square with some of the scenarios about which we have read.
Customs conducted its own survey earlier this year to arrive at an estimate of revenue evaded by smuggling. That estimate provides a similar figure of £210 million for all alcoholic drinks, but with a much larger share attributable to beer, at £110 million. The actual loss of

revenue will be less, since some of the smuggling is likely to represent additional consumption. Taking legitimate cross-border shopping and smuggling together, this represents less than 5 per cent. of the UK's beer consumption. The total tax collected on beer was over £4.7 billion last year.
That is not to say that we are doing nothing about the problem, or that Customs is not paying attention to this vital area. The top priority is to catch the smugglers.

Mr. Alan Meale: Customs and Excise forecasts that by the year 2000 illegally imported alcoholic drinks will have doubled in quantity—a frightening statistic that will mean hundreds of millions of pounds in lost revenue. With Customs and Excise already stretched to the limit, does the Minister agree that action is needed now?

Mrs. Knight: I was just coming to that. What are we doing about the smuggling problem? Smuggling, dealing in smuggled goods and buying smuggled goods are all crimes. Customs has 300 staff employed on single market work, most of them directly involved in the anti-smuggling effort. Many, if not most, of them work at the ports, but some work inland providing intelligence. For instance, they are watching more closely the frequent crosser—but my hon. and learned Friend will excuse me if I do not go into the detail of what we are doing to stop smugglers. We do not want to give them notice of our intentions.
My hon. and learned Friend used the argument about harmonisation—that harmonising duties across the European Union would spell the end of smuggling as a problem. Some heavy costs are associated with that. A reduction of 10 per cent. in the duties on alcohol would result in a loss of £500 million to the Exchequer. To reduce our duties to French levels would cost roughly £3.5 billion. That is the sort of sum in question. We take every opportunity to press our case in the Commission. We want other countries to adopt a more practical attitude to alcohol duties.
It is true, as my hon. and learned Friend said, that the Treasury model has been used by some observers, but that model does not cater for the narrow, specific area of one industry, such as the brewing industry. We are discussing with those involved the reasons why their estimates are incorrect.
I conclude by reiterating that we take the matter extremely seriously. All the issues raised by my hon. and learned Friend will inform the decisions of my right hon. and learned Friend the Chancellor with regard to the Budget that he will present to the House next week.

Causeway Hospital, Coleraine

Mr. William Ross: I am sorry that I have had to raise this matter on the Floor of the House. I had hoped that tender documents for the hospital would already have been out, but they are not. I must therefore ask the Minister the reasons for the delay.
The debate on how best to provide good-quality medical and hospital treatment for Coleraine and the surrounding area has been going on for many years. I was told today that at least one person was brought over from England in 1952 to help to design the Coleraine hospital. For much of the time since then, there has been a deep division as to whether there should be one hospital or two—one at Coleraine and another at Ballymoney.
The matter was finally settled in favour of a single hospital at Coleraine, and the debate then began as to whether the existing site should be used, or whether it would be better to create the badly needed acute hospital in a brand new green-field location. The latter option was finally accepted, and a site was identified and purchased on the outskirts of Coleraine.
There is no question about the need for the provision of comprehensive hospital services in the Coleraine and North Antrim areas. In the catchment area, there is a population of about 110,000; that number doubles during the summer months, owing to the movement of many people to the north coast, which, as the House will know, is a major tourist attraction.
The present hospital is, to put it mildly, in a poor and deteriorating condition. For example, the out-patients department is still housed in wartime nissen huts. Such accommodation was never suitable for that purpose. The buildings, which were a second world war temporary construction, were originally designed to have a 10-year life. After the war, many such buildings were purchased by farmers and used to house farm animals, potatoes, turnips, chickens and everything else. All the animals, the farm produce have long since disappeared, but people are still using the huts. That is unacceptable.
The medical wards are prefabricated buildings, which are also long past their expected life span. In addition, many non-clinical services are long overdue for upgrading. The kitchens, the boiler plant and the mechanical and electrical services all need urgent work. When there is heavy rain, buckets are needed to catch the leaks. I understand that the mortuary is the most recent part of the hospital to come under assault.
Given the situation in the hospital, the board and the trust have been unwilling to spend money on major repairs in recent years, as they were aware that the new Causeway hospital was due to come into use—originally by 1999, but, according to a more recent estimate, by the end of 2000 at the latest.
The result is that, if the new hospital does not go ahead now, the necessary upgrading to meet the immediate requirements of the statutory authorities, which in the circumstances have been very fair to the hospital, are currently estimated to cost £5.3 million. To bring the facilities up to modern standards would cost £26 million, and we would still be left with an old hospital and worn-out buildings.
The site of the present hospital is a valuable one, right in the centre of Coleraine. No doubt it will bring a considerable sum to the coffers of the trust when it can be sold, as soon as the new hospital is built.
I am deeply concerned about the seemingly endless delays in starting building work, and my concern is shared by the entire community that is to be served by the new hospital.
The need for the hospital, its clinical profile and the estimated costs have been examined in detail no fewer than four times, and every time the need for the hospital was proven. The original option appraisal exercise took place in 1990. It was detailed and thorough, and concluded that the hospital must be built. There was a review in 1993 and early 1994 on new targets and throughput, and another review later in 1994 regarding a reduction of 4,000 sq m relating to capital charging. A further review was conducted later in 1994 and early 1995. To everyone's astonishment, a fourth review was called for during the current year, which ended with the same result. Such a detailed examination of a proposed new hospital is unprecedented.
It is clear from various letters that the questions raised by the Department were simply nit-picking, for the issues could and should all have been dealt with far more expeditiously. Two or three meetings at senior level with the board and the trust should have sorted out all the problems, without the endless inquiries that have been made.
The attitude of the Ministers involved in the saga has been plain. The right hon. Member for Richmond and Barnes (Mr. Hanley), who originally gave approval in 1992, was forthright. He stated on 28 January 1992 that he had identified the funds and set out the time scale—he said that it was the only realistic time scale—and he expected the new hospital to open in 1999. He said that he hoped that his announcement would facilitate the process—he was referring to a process of rationalisation between the existing hospitals—by reassuring those who may have harboured doubts about the depth of the Government's commitment to the construction of the new Causeway hospital.
Baroness Denton, who was formerly in charge of this aspect of Northern Ireland's government and provision, gave a verbal assurance to Mr. Bill Tweed, the chief executive of the Causeway trust, on 15 July 1994. Her predecessor, Lord Arran, gave the same assurance on 22 December 1993—a lovely Christmas box, which has not yet been delivered. The present Under-Secretary of State for Northern Ireland, the hon. Member for North-East Cambridgeshire (Mr. Moss), who I am glad to see on the Front Bench, renewed the assurance twice, on 18 January 1995 and again to me personally on 22 March 1995.
To date, £7 million has been spent on site purchase, the new laboratory, professional fees and considerable siteworks. I have a colour photograph showing the entire area—wonderful roads and entrance, but unfortunately no hospital. The difficult rationalisation process, which the right hon. Member for Richmond and Barnes considered a vital prerequisite in 1992, has been put into effect, not without some difficulty and resistance. It was driven through by the board and the trust on the basis that the new hospital was coming. I am told that the result of the final examination requested by the Health and Social


Services Executive has recently been delivered, and it shows that any redesign at this stage would be quite uneconomical.
The result of all this is that the trust is ready to go ahead once the Minister gives clearance for the project, and there is no reason why he should not do so, for, in the expenditure plans and priorities for Northern Ireland published in March this year, the sums required were set out on page 260, in table 9.29.
There is one error, in that the original year of completion was to be 1999, not 2000, as shown in the publication, and the sums already expended are slightly higher than those shown, but that is not unexpected. The provision for 1996–97 is just over £8 million, so in March this year the Government were still on course, and clearly expected the project to go to tender before the end of 1996. The documentation should have been finalised, and they should already be in the process of seeking tenders.
The estimates included sums for the redevelopment of the Royal Victoria and Altnagelvin hospitals. Altnagelvin was in the 1995 expenditure plans. The Royal Victoria was not, but the 1996 estimate shows that some £5 million will be spent in the relatively near future.
Given the history, it is perfectly clear why my constituents and I were sure that we could rely on the assurances that I have mentioned, plus private chats with Ministers down the years, all of which were given on behalf of the Government by so many Ministers on so many occasions. We were certain that the hospital would be built. But all the time, nagging concerns were expressed to me at various times by the professionals involved, by the medical establishment in the catchment area, by the local council and by members of the general public, who, naturally, were taking a keen interest in these matters.
I was concerned enough to write to the Minister on 20 September last. To be frank, his reply of 22 October thoroughly alarmed me, for there seemed a definite retreat from the assurances that were given. I did not like the resiling that I saw in the letter.
My alarm is rapidly turning to anger, for I am also aware that, despite the fact that approval for the Causeway hospital was given so long ago—at the beginning of 1992—the Royal Victoria, which received approval in May 1993 for its refurbishment, redevelopment or whatever, and Altnagelvin, which received approval for its major works in 1994. are at precisely the same stage as the Causeway hospital project. It is quite remarkable that they have managed to catch up, but it is not without significance that neither of those two projects ever had a comprehensive review at the beginning. They had in comparison a very casual examination of what was required and proposed. It is remarkable, and we need a fuller explanation.
The entire community wants to know why the Coleraine project has been subjected to these long delays, all of which lay within the Department. Much money has been spent. The site is ready. The design and commission teams are in place and are already paying for their rented accommodation. Frankly, they will run out of work if the project does not go ahead. They will soon have to be disbanded, and it will be difficult to get them back together again. The list of contractors has been selected.
The trust is ready to go, despite the obstacles put in its path. Many hoops were put up, and the trust and the board hopped neatly through them one after the other.

The contractors met all the deadlines as soon as humanly possible, and much sooner than some persons would have liked. They are ready to roll.
The perception of the community that would be served by the hospital, particularly in Coleraine, is that the Causeway is the victim of a sustained campaign of discrimination. Only a clear commitment to go ahead now would remove that perception from the minds of my constituents.

Rev. Ian Paisley: This is a very serious matter for the hon. Member for East Londonderry (Mr. Ross) and for myself. I remind the Minister that large sums were spent through the Province on a promise that the Waveney hospital in Ballymena would be the main acute hospital in the area. The tragedy is that, with the closing of the hospital in Ballycastle and the rundown of the hospital in Ballymena, there is currently no acute service hospital nearer than Antrim for my constituents. If the Causeway hospital does not go ahead, all the people, from as far north as Ballycastle, will have to travel to Antrim.
This is a very serious matter, and all of us are seriously concerned about it. We thought that we had it resolved by the promise of a new hospital in the hon. Gentleman's constituency but on the periphery of my own. It was called the Causeway because it was to serve both communities. As the hon. Gentleman said, Minister after Minister—the right hon. Member for Richmond and Barnes (Mr. Hanley), the Earl of Arran, Baroness Denton and the hon. Member for North-East Cambridgeshire (Mr. Moss), who will reply today—gave us assurances on two occasions.
There are serious questions that the Minister must answer today. First, why all the reviews? It seems strange that one review is carried out in September 1994 and another in October 1994. Why? No other new hospital in our country has had such treatment. The hon. Gentleman is right: people are saying that there is discrimination in this case. This has not happened in the other new hospitals built. An appraisal was carried out in 1995. In June 1996, there was yet another. Why all these appraisals, when it was decided that the hospital was needed and that it would be built?
Then, of course, we have the fact that the Causeway hospital development group met monthly for four years. It has had 49 meetings. Now there is a question mark over the whole affair. What about the promises made to the medical staff, and the rationalisation that was necessary for the configuration of the new hospital?

Rev. Martin Smyth: The hon. Gentleman speaks of rationalisation. Does he recall that, between 1982 and 1986, the Northern Ireland Assembly agreed that rationalisation should proceed? At that time, as Chairman of the Finance Committee, I asked whether slippage money could be used for rationalisation, and millions were returned to the Treasury.

Rev. Ian Paisley: I recall that very well, because it was a matter about which people were urgently concerned. Promises were made to staff, particularly consultant medical staff, on the radical changes that were to take place because of the new hospital.


Will the Minister confirm that the Causeway hospital site cost £0.85 million, the Causeway laboratory £1.89 million, the advanced siteworks £1.18 million and the main project £2.4 million? What is the estimated cost of the total upgrading of the present facilities if the delay is lengthened? Has the commissioning team been stood down? Have officers' leases ended? If the design team is stood down, will its members seek compensation? What is the position on putting out tenders? When will tenders be issued?
I know that the Minister is concerned about the matter—he is not unsympathetic. However, we must answer to our constituents, and we need answers today at the Dispatch Box.

The Parliamentary Under-Secretary of State for Northern Ireland (Mr. Malcolm Moss): I am grateful to the hon. Member for East Londonderry (Mr. Ross) for the opportunity to outline the Government's record and position in relation to the Causeway hospital. I recognise that the matter is close to his heart. Similarly, I know that the hon. Member for North Antrim (Rev. Ian Paisley) is committed to the project. Perhaps more importantly, I am aware of the concerns of the local population from the range of correspondence which has come to me recently.
As the hon. Members helpfully explained, the campaign for a new hospital serving the Causeway area has been active for many years. In 1976, the Northern health and social services board set out its strategy for the development of acute hospital services. It was based on the provision of two modern hospitals to rationalise and concentrate services from a range of small dispersed units which were in poor condition and hopelessly ill equipped to meet the needs of modern clinical practice and standards of care.
A new area hospital at Antrim is to serve primarily the southern part of the board area, and the northern end of the board area is to be served by a new hospital in the Coleraine area, which would enable rationalisation of the Coleraine, Route, Robinson and Dalriada hospitals.
As hon. Members are aware, the first element of the strategy was finally achieved—after a slight delay—with the opening of the Antrim area hospital by the Secretary of State in 1993. The development of services in Causeway was planned to follow upon completion of the new Antrim hospital. From 1988 on, the Northern board appointed management consultants to look at the options. The then unit management and Coopers and Lybrand were involved, and, after considerable analysis, in December 1991 the Government approved and accepted the option to build a new hospital on a green-field site at Lodge road, Coleraine.
Shortly after that, in January 1992, my predecessor, my right hon. Friend the Member for Richmond and Barnes (Mr. Hanley), announced the timetable for the project. It was envisaged that detailed planning and design would commence in 1994, with the major construction phase beginning in 1997 and the project to be completed by 2000. The speed with which the result of the option appraisal was translated into a programme of action with supporting funding reflected the Government's priority for, and commitment to, the project.
Over the past four years, the local population has seen that commitment demonstrated by physical investment. The proposed site was purchased at a cost of £0.85 million, and the first and essential stage of the development, the new area laboratory, was built on the site at a cost of £2.7 million. It became operational in 1994. Those investments, plus expenditure on landscaping and initial design fees, bring the total spend to date to £8.35 million. I hope that hon. Members will agree that that represents a considerable investment already in the light of pressures on public expenditure and the competing investment priorities.
At the same time, it is important to ensure that the original case for such major investment remains valid over the necessarily lengthy planning period. The acute sector has seen many changes in the past decade: productivity has increased significantly, and clinical practice has seen the expansion of day surgery. Hon. Members may recall that, in 1993, the Public Accounts Committee examined acute hospital provision in Northern Ireland. In the memorandum of reply to the Committee, my Department gave a commitment that all proposals for major investment would be kept under constant review and the underlying assumptions would be tested before any final decisions were taken.
As the Minister responsible for health and personal social services in Northern Ireland, I am keen to endorse that commitment to ensure that what is built at Causeway and elsewhere is demonstrably what is needed, and no more than that. Therefore, at my request, earlier this year the health and social services executive asked the Causeway trust to review the case supporting the investment. In the light of the new regional strategy that I issued in July, I was particularly anxious to ensure that investment in a new hospital in Coleraine was consistent with the vision for acute hospital services set out in that strategy. The trust was therefore asked to ensure that the investment was acceptable and affordable to the principal purchaser, the Northern board.
I am pleased to record that the trust tackled that exercise in a rigorous and comprehensive manner, submitting a detailed review carried out by Coopers and Lybrand. The Causeway trust board has acted with commendable professionalism, urgency and diligence, and I take this opportunity to thank the chairman, the chief executive and board members for their co-operation throughout.
As a result, the executive identified a number of issues as requiring clarification by the trust and the board. The trust again dealt with them expeditiously and, as a result, the executive wrote to the trust on 5 November to inform it that the case for the investment had been revalidated. The executive advised the trust that, because of the additional costs involved with a redesign, it would not be economic—I confirm the hon. Gentleman's earlier comments—to seek a reduction in the project design.
As hon. Members are probably aware, the Government have reaffirmed the need for the new Causeway hospital to provide a locus for the acute services to the local population in the next century. The matter now rests with me in terms of a decision on the next stage of the project. Hon. Members will be aware of the pressures on public expenditure in general. My right hon. and learned Friend the Secretary of State will soon announce decisions on public expenditure in Northern Ireland following the Chancellor's Budget statement. Hon. Members will


recognise the added pressures on public funds in Northern Ireland caused by the ending of the IRA ceasefire and the consequences of the summer's unrest.
The projected investment at Causeway—about £40 million—is significant. As Minister responsible for health and personal social services, I have a responsibility to ensure that such investment decisions are affordable and deserve the top priority with other pressures on my programme. I shall look at those issues once the Secretary of State has taken his decision, and I hope to make a statement before long.
To sum up, I believe that the Government have an impressive record of achievement already with the Causeway hospital project. The investment appraisal was approved quickly and a firm timetable was set out. Significant public funds have been made available and allowed preliminary investment on the site. We have ensured that the project remains tight, affordable and thus value for money for the taxpayer. The timetable set out by my right hon. Friend the Member for Richmond and Barnes has largely been adhered to.
I recognise the local population's wish that we move on to the last major phase, but I ask hon. Members in the Chamber today for some forbearance over the present delay. I am likely to face difficult decisions over health spending next year, and decisions on Causeway must be part of that process, not taken outside it or ahead of it.

Rev. Ian Paisley: Will the Minister assure the House that he will meet Causeway trust members and converse with them?

Mr. Moss: I have already given that assurance to the hon. Gentleman and to the hon. Member for East Londonderry. I am more than happy to meet Causeway trust members. They have not asked for a meeting at this stage, but my door is always open to any trust board members who wish to talk to me.
In determining the way forward, I assure hon. Members that I hear and understand their concerns and those of their constituents. They can be sure that I shall give them due weight in the weeks ahead.

It being Two o'clock, the motion for the Adjournment of the House lapsed, without Question put.

Sitting suspended, pursuant to Standing Order No. 10 (Wednesday sittings), till half-past Two o'clock.

NEW WRIT

For Barnsley, East, in the room of the hon. Terry Patchett, deceased.—[Mr. Dewar.]

SCOTTISH BORDERS COUNCIL (JIM CLARK MEMORIAL RALLY) ORDER CONFIRMATION BILL

Mr. Secretary Forsyth presented a Bill to confirm a Provisional Order under section 7 of the Private Legislation Procedure (Scotland) Act 1936, relating to Scottish Borders Council: And the same was read the First time; and ordered to be read a Second time on Tuesday 26 November and to be printed. [Bill 13.]

WESTERN ISLES COUNCIL (BERNERAY CAUSEWAY) ORDER CONFIRMATION BILL

Mr. Secretary Forsyth presented a Bill to confirm a Provisional Order under section 7 of the Private Legislation Procedure (Scotland) Act 1936, relating to Western Isles Council: And the same was read the First time; and ordered to be read a Second time on Tuesday 26 November and to be printed. [Bill 14.]

Oral Answers to Questions — SCOTLAND

Inward Investment

Mr. Dykes: To ask the Secretary of State for Scotland what investment from abroad has been attracted to Scotland in 1996 to date. [3459]

The Parliamentary Under-Secretary of State for Scotland (Mr. George Kynoch): Record levels of investment have been attracted to Scotland in 1996.

Mr. Dykes: What conclusion does my hon. Friend draw from those record levels, from the forthcoming announcement about the massive Hyundai project and from the general outlook for economic activity and tax matters?

Mr. Kynoch: I think that my hon. Friend meant the recent and not the forthcoming announcement about Hyundai. The Hyundai project has already been announced, and it is excellent news for the Dunfermline area. There will be 2,000 new jobs and inward investment of £2.4 billion, which is the largest ever in Europe.
My hon. Friend is right—companies come to Scotland because it is a competitive, low-tax country. The Opposition's proposals will be bad for inward investment: whether it be their spending pledges, which it is reckoned will increase taxation by 9p, the extra 3p that they intend to impose through a tartan tax, their proposals for a uniform business rate, which will be an extra tax on business, or their trade tax. We would not continue to attract the record levels of investment that we currently enjoy under the Government.

Mr. Maxton: Does the Minister seriously expect the House to believe that investors who come to Scotland do not know full well that Labour will win the next election, and that we shall establish a Scottish Parliament with tax-raising powers? If that is so, why are they not put off coming?

Mr. Kynoch: The hon. Gentleman should give inward investors a little more credit than that. They possibly look a little further ahead. They do not believe that the Labour party will win the next general election: they believe that the Government, with their beneficial policies for business and for the economy in Scotland, will continue for many years to come.

Sir Hector Monro: On the matter of incentives, does my hon. Friend agree that it is right to bring it home to the House and to Scotland that no one would want to come to a country where income tax was 9p higher, the tartan tax was 3p and where there was an unknown trade tax, all of which have been proposed by Labour? Those proposals must be the biggest disincentive for anyone to come to Scotland that there has ever been.

Mr. Kynoch: My right hon. Friend is right. Businesses are concerned about their competitiveness. All businesses must exist in a highly competitive marketplace, so

anything that makes them less competitive is bad. The social chapter, the minimum wage and the taxes to which my right hon. Friend referred, and which I mentioned earlier, would be bad for competitiveness, and thus bad for business, and would make inward investors think twice before they came to Scotland.

Mr. Wallace: The Minister has talked, not unreasonably, about the jobs that we already secure from inward investment. How does he feel about the threat of what might be described as predatory investment by Norwegian salmon farming companies in Scotland, which might buy up Scottish salmon farms? Those farms are made less viable by the currently plummeting price of salmon.
I accept that the Minister's colleagues in the Scottish Office appear to have been batting for the salmon farming industry, but their view does not seem to be shared throughout Government. What prospect can be offered to the salmon farmers of a minimum import price in the near future, so that they can try to secure the home-based Scottish industry that is so vital?

Mr. Kynoch: The hon. Gentleman is absolutely right. Salmon farming is an important industry, particularly in the highlands and islands. My right hon. Friend the Secretary of State is already discussing the matter with colleagues, and my hon. Friend the Member for Aberdeen, South (Mr. Robertson)—the Minister responsible for fisheries—is going to Norway on Monday to discuss issues relating to the salmon farming industry.

Mr. Gallie: What proportion of inward investment comes into Scotland through private finance initiatives? If the PFI relating to the new Scottish air traffic control centre were accepted, would that not increase inward investment further?

Mr. Kynoch: As a firm advocate on behalf of both Ayrshire and Prestwick, my hon. Friend knows only too well that we have recently had significant success with Rohr's investment in Prestwick. We continue to hold discussions with British Aerospace in Prestwick, to ensure that it is given all the support that it needs to develop further. I know that my hon. Friend is also a firm advocate of the air traffic control centre at Prestwick, and I am sure that my colleagues in the Department of Transport are well aware of his concerns.

Mr. Hood: Is it not the case that, although the Government have 11 per cent. support in Scotland and trail Labour by over 20 per cent. in the United Kingdom, we still have an increase in inward investment? Could it be that those who have invested in Scotland consider their investment worth while because of the impending Labour Government and Scottish Parliament?

Mr. Kynoch: I must tell the hon. Gentleman to dream on. As I have said, there is no doubt that businesses that look to Europe and the United Kingdom for investment potential take into account the competitive circumstances that they can enjoy in Scotland. Clearly, anything that is likely to put that in jeopardy—such as higher taxation in Scotland, which is an inevitable consequence of the


Opposition's policies—would reduce competitiveness, and make businesses think twice before coming to Scotland.

Mr. Beggs: Does the Minister recognise that the prosperity of Dumfries and Galloway has a considerable impact on the Northern Ireland economy? Can he assure us that the region is given equal prominence as a suitable location for new inward investment in Scotland?

Mr. Kynoch: I can assure the hon. Gentleman that all areas are given equal attention by Locate in Scotland when it comes to inward investment. The decision where to locate is made by inward investors themselves, and they will inevitably consider their individual circumstances in judging where they will find the skilled labour force that they may be seeking, and where they will secure the best access to their marketplace or suppliers. Nevertheless, I can tell the hon. Gentleman that no part of Scotland is not promoted by Locate in Scotland; the whole of Scotland is promoted, and long may that continue.

A96 Fochabers Bypass

Mrs. Ewing: To ask the Secretary of State for Scotland when he will make an announcement on the route of the A96 Fochabers bypass. [3460]

The Secretary of State for Scotland (Mr. Michael Forsyth): I have been reading the hon. Lady's local newspaper, the Northern Scot. I see that she has been saying one or two rude things about the Government, and me in particular, with regard to this subject.

Mr. Canavan: That is what she is paid for.

Mr. Forsyth: I am not sure that that is what she is paid for. She is paid to make representations on behalf of her constituents, which she does with considerable vigour. I am delighted to tell her that I shall be publishing a line of route for the bypass, and that I have now decided on a northern route for the town.

Mrs. Ewing: I welcome the Secretary of State's decision, but why has the Scottish Office taken some seven months to analyse the 700 responses from my constituents in connection with the Fochabers bypass? In the Scottish Office, there has been a bottleneck as tight as the traffic bottleneck in Fochabers. When will the work commence, because what is important is not just his decision but the commencement? After 20 years of campaigning for the bypass, why cannot we have it before the millennium?

Mr. Forsyth: All that I can say to the hon. Lady is that officials' advice on the matter reached me this morning and I took the decision immediately so that I could give her the answer that no doubt accounts for the smile on her face.
On the construction of the project, the hon. Lady will know that officials will now have to work up design proposals, in consultation with the local community. We shall then have to publish the draft orders. I assure her that that will be done as speedily as possible.

Mr. Bill Walker: Does my right hon. Friend agree that the news of the Fochabers bypass is welcome and that it involves much public money? Does he recognise that the new hospital in Elgin, costing about £30 million—

Madam Speaker: Order. It is a good try, but the question is on the Fochabers bypass. I know Scotland rather better than the hon. Gentleman thinks that I do. Let us stay with the Fochabers bypass.

Mr. Walker: My point is directly linked to the Fochabers bypass because the funds available for the bypass would not be available under Scottish National party proposals to renationalise the bus industry, Skye bridge and Railtrack. Does that not demonstrate the SNP's fairy tale economics?

Mr. Forsyth: There is a link between Dr. Gray's hospital in Elgin and the bypass in so far as one leads to the other if one travels in the right direction. Both are projects for which the hon. Member for Moray (Mrs. Ewing) has campaigned. I have had the pleasure over the years of being able to announce approval for both projects because we are part of the United Kingdom and of the Union and therefore are able to afford that.

Industry (Taxation)

Lady Olga Maitland: To ask the Secretary of State for Scotland what representations he has received from the business community about the effect of the level of taxation on Scottish industry. [3461]

Mr. Michael Forsyth: The Scottish business community is opposed to Labour's tartan tax and to its proposals to introduce a new trade tax by abolishing the uniform business rate.

Lady Olga Maitland: Does my right hon. Friend agree that the proposals to allow local authorities to set the business rate would sink businesses without trace? They would be faced with enormous tax burdens. That would mean that jobs would be lost and businesses would go under. It would add to the burdens of Labour's proposals for a tartan tax increase of 3p in the pound and for an income tax increase of 9p in the pound. Does he agree that there is only one thing for businesses to do: stay with the Conservatives because we shall keep jobs for all?

Mr. Forsyth: I agree with my hon. Friend and commend to her the document "New Labour's Public Expenditure Plans", which was published by my right hon. Friend the Chief Secretary today and which shows that, in addition to the 9p on income tax, we would have to pay 3p in tartan tax and of course the trade tax, which would be levied as a result of abolition of the uniform business rate. The news of consolation from the hon. Member for Hamilton (Mr. Robertson) is that the business rate increases would be limited to increases imposed by


Labour councils on the council tax payer, so, in Glasgow last year, business rates would have increased by 19 per cent. That is meant to be the consolation.

Mr. McKelvey: Does the Secretary of State not know that we all know his expertise in taxation? Will he tell the truth and say that, by placing VAT on fuel—a move to which he was a party, and for which he voted—the Government created the most devastating tax that Scotland has had to face since the infamous poll tax? How will he advise old-age pensioners on the issue of whether they should eat or heat?

Madam Speaker: Order. The question deals with the level of taxation on Scottish industry. I hope that the hon. Gentleman will make his question pertinent to it.

Mr. McKelvey: You are absolutely right, Madam Speaker; I got carried away. Is the Secretary of State aware that the business rate paid by industry is only one of the injuries that it has received, and that, this winter, many businesses will lose staff who have to take time off because they have caught colds, because the VAT placed on their rates has created a cold climate in an even colder climate?

Mr. Forsyth: That is the first time that the Government have been blamed for the cold climate. On the hon. Gentleman's concern about the effect of taxation on energy prices, he might like to have a word with his own Front Benchers about the windfall tax, which will do precisely what he is complaining about. As for his point on businesses and jobs, we are currently committing about half a billion pounds a year to maintaining the uniform business rate. Labour would throw away the rate and the competitive advantage that it provides for Scottish business, and fund the extravagant proposals made by Labour-controlled local government, which, in the current year, amount almost to an extra half a billion pounds of expenditure.

Mr. Stewart: Does my right hon. Friend agree that Scottish industry should be extremely concerned about the prospect of a Scottish Parliament that would have unlimited powers to pass legislation on the level of business rates in Scotland? Does he agree that Scottish industry should, as a matter of the highest priority, endeavour to establish precisely the Labour party's policies on those matters by consulting the hon. Member for Hartlepool (Mr. Mandelson)?

Mr. Forsyth: I agree with my hon. Friend on where policy appears to be made, and on the need for concern about the effects of a tax-raising Parliament on the business community in Scotland. Not only would we have to pay a tartan tax, which would mean a 15 per cent. increase in the starting rate of income tax, but funding for our vital services would be put at risk, with all the consequences that that would have for Scottish industry. Furthermore, we would have increases in the business rate, which would destroy jobs, investment and prosperity in Scotland.

Sir David Steel: Is the Secretary of State aware that, following the death of the General Franco, there was, in 1977, an exactly similar debate in Spain? Many Spanish

businesses doubted the wisdom of setting up the Catalan Parliament, and the "poncho peseta" phrase stood in for the "tartan tax". Is he aware that, if he were now to go to Barcelona, he would not find anyone against the Catalan Parliament, because it has been such a success politically, economically and culturally? Why does he think that Edinburgh would do less well?

Mr. Forsyth: I am surprised at the right hon. Gentleman. If he has made a study of the Catalan Parliament—which may explain why we do not see so much of him here—he will know that the Catalan Parliament is a net contributor to Spain, and that the Catalan economy contributes to the rest of Spain. The situation is the other way round in Scotland. That is why a Scottish Parliament risks our vital public services and why I am surprised that the right hon. Gentleman is still supporting the Constitutional Convention—whereas Lord Ewing, a former Labour Minister, at least had the dignity to resign in disgust at the shambles created by the hon. Member for Hamilton.

Mr. John Marshall: Does my right hon. Friend agree that, if there were to be an independent Scotland or a Scottish Parliament with tax-raising powers, Scottish industry would have a much higher burden of taxation, which would destroy jobs and inward investment, and the unemployment rate in Scotland would reach the level that it is in Spain—as recommended by the former leader of the Liberal party?

Mr. Forsyth: If we had an independent Scotland, we would have a budget deficit problem of about £8.1 billion, and the future of Scottish industry would be an academic consideration.

Mr. George Robertson: Is there not something of a brazen, brass-neck cheek about the inventor of the poll tax accusing anybody else on the subject of taxation? At the last election, the Secretary of State's party told Scotland, including Scottish industrialists, that it would reduce taxation year on year, but it has put up taxes 22 times—the equivalent of 7p on the standard rate of income tax—since then. His party has put VAT on heating. The cold and windy days in Scotland make that the Tory heating tax, and it is felt deeply by everybody. The Government cannot tell the truth about their own tax plans, so why should they expect anybody to believe the lies that they tell about Labour's tax plans?

Mr. Forsyth: There was a moment's frisson when I saw the right hon. Member for Glasgow, Garscadden (Mr. Dewar) sitting in the hon. Gentleman's place and I thought that we might be in for some serious opposition. If the hon. Gentleman finds what we have to say about Labour's tax plans incredible, perhaps he would like to look at a document that has been produced by my right hon. Friend the Chief Secretary, "New Labour's Public Expenditure Plans"—

Mr. Hood: It is lies.

Mr. Forsyth: The hon. Gentleman says that it is lies, yet all of it is in the words of Opposition spokesmen.

Further Education Colleges

Mr. Worthington: To ask the Secretary of State for Scotland how many further education colleges in Scotland were allocated less money by him in this financial year than last year; and what factors underlay this decision. [3463]

The Parliamentary Under-Secretary of State for Scotland (Mr. Raymond S. Robertson): Twenty-one, according to the formula.

Mr. Worthington: I thought that 22 out of the 43 colleges had received less money this year than they did last year. Given that the Minister is budgeting for further education in Scotland to get less money next year, he is saying that, no matter how many colleges work well and attract more students, at least half of them will receive less money next year. What sense is there in such a Government policy?

Mr. Robertson: The hon. Gentleman is totally mistaken. No spending plans on how much will be allocated to further education have yet been decided. He stands up and says that there will be less money, but he does not have a clue how much money will be allocated next year. All I can say is that we have increased spending on further education colleges every year since incorporation in 1993.

Mr. Nigel Evans: Does my hon. Friend believe that, if we went down the route of taking away child benefit from those aged 16 to 18 who hope to go on to further education, it may mean that a number of people who might have stayed on to do A-levels at school will be dissuaded from doing so and will have to go out and find a job? There will therefore be fewer people going on to further education.

Mr. Robertson: My hon. Friend is right. The teenage tax proposed by the Labour party would hit Scots young people harder, since more young people stay on in school in Scotland than in any other part of the United Kingdom. Labour's tax is uniquely designed to hit the young people and families of Scotland.

Mrs. Fyfe: If the Minister is going to encourage his colleagues from southern constituencies to come to Scottish questions, could he first give them a crash course in Scottish education and other matters? How does he expect Scottish industry to thrive if there is not sufficient expenditure on further education courses?

Mr. Robertson: Here we have yet another spending pledge from the Labour party. The hon. Lady seems to forget that we now have more students, studying more courses and getting more and better qualifications in our colleges under record funding from the Government. She would do the further education sector in Scotland a great service if she for once—just once—recognised that.

Mr. Ian Bruce: Do the Scottish further education colleges use the same formula as those in England and Wales? If they do not, do they get less than those in England and Wales, or more?

Mr. Robertson: Further education colleges in Scotland are, of course, funded more than equivalent colleges in

England. The funding formula that we introduced last year, after full consultation with the colleges, is rewarding student activity and efficiency in colleges, which is surely the right way forward.

Mr. Charles Kennedy: Does the Minister recall that, during an exchange in Scottish questions just before the summer recess, he agreed that a meeting with my hon. Friend the Member for Caithness and Sutherland (Mr. Maclennan) and myself concerning the funding problems that are being encountered by various colleges, such as Inverness and Thurso, in the north would be appropriate? Given that final decisions have not been taken, but those colleges are, like others—as the hon. Member for Clydebank and Milngavie (Mr. Worthington) said—likely to have future funding problems, could we have that meeting before spending decisions are taken?

Mr. Robertson: The hon. Gentleman is right. I offered a meeting to him and the hon. Member for Caithness and Sutherland (Mr. Maclennan). They have never got back to me to arrange that meeting. Of course I should be delighted to see them.

Mrs. Liddell: Why does the Minister deny that, in 1995, the Government cut £1 1 million from their previous plans for funding further education in Scotland? Those cuts are not sustainable without redundancies and a diminution in the quality and range of teaching in Scottish further education colleges. Will he accept that his inability to protect Scottish education from the narrow dogma of the right hon. Member for Stirling (Mr. Forsyth) is undermining Scotland's economic future?

Mr. Robertson: Only the hon. Lady could turn an 11 per cent. increase into a cut. Today of all days, she has suggested that the £233 million that we spent last year on further education is not enough. If she was being honest, she would have said how much she would spend. Would she spend another £50 million? Another £60 million? Another £70 million? For us to have an informed debate on further education funding, she must come up with her figures. I stand by what we have done. The hon. Lady is not in a position to respond to me during Question Time, but I give her notice that I shall write to her this afternoon. I hope that she will be able to write back, telling me how much more than our £233 million she would put in were she in my position.

Expenditure and Taxation Levels

Mr. Barry Field: To ask the Secretary of State for Scotland what recent representations he has received on (a) expenditure and (b) taxation levels in Scotland. [3464]

Mr. Michael Forsyth: I have received a number of representations on expenditure and taxation levels in Scotland.

Mr. Field: Is it not a fact that the cut in duty has brought a warm cheer to the Scotch whisky industry of Scotland—more than adequate compensation for a cool climate? Is it not also a fact that the Scottish people get an excellent bargain from the Government and the British taxpayer? They have more Members of Parliament per head and more expenditure per head than the people of


the Isle of Wight, yet they still mutter and moan into their sporrans. If we had that level of expenditure per head on the Isle of Wight, we would do an island fling.

Mr. Forsyth: It is certainly true that my right hon. and learned Friend the Chancellor of the Exchequer broke with the tradition of 100 years in last year's Budget by cutting the duty on whisky for the first time. I hope that that splendid new tradition will be continued.
My hon. Friend is right to say that Scotland enjoys considerably higher levels of public expenditure. I believe that that is a benefit for the Union. Despite what I am sometimes tempted to think when looking at Opposition Members, I also believe that it is a benefit for Scotland to have proportionately more Members of Parliament. In addition, we enjoy the office of Secretary of State—a Cabinet post that provides an important strong voice for Scotland. All those factors—the higher expenditure level, the representation at Westminster and the role of the Secretary of State—would be destroyed by Labour's plans for a tax-raising Parliament.

Mr. Graham: Is the Secretary of State aware of the acute crisis in local authorities caused by his Government's savage cuts? Next year, a catastrophic unemployment rate will escalate among local authority workers who provide the services for our people. There will be further cuts in home help and in all local authority services because of the Government. Local government services will once again be decimated.

Madam Speaker: I hope that the Minister heard a question. I did not. Perhaps he would respond anyway.

Mr. Forsyth: I prepared an answer earlier. I think that the hon. Gentleman's question was about the need for more local authority expenditure. I draw his attention to Glasgow. Last year, I gave Glasgow an additional £15 million in aggregated external finance and was criticised by the hon. Member for Hamilton (Mr. Robertson). We now find that the council is unsure of how many social workers it employs in its social work department. It does not know the number. It has also overspent its budget by £3.5 million. Local authority expenditure in Scotland is 30 per cent. higher than in England. Grant support from central Government is 44 per cent. higher. The problem with local authorities in Scotland is that they are run by the Labour party, not that they are underfunded by the Government.

Mr. Gallie: Will my right hon. Friend confirm that half of the United Kingdom regional aid budget was spent in Scotland last year? If a Scottish Parliament were established, does he believe that that would continue?

Mr. Forsyth: I do not believe that it would continue. It is hard enough maintaining that level of expenditure at present, given our voice in the Cabinet, our representation, and our ability to make our case where the decisions on funding would continue to be made even if we had a Scottish Parliament. I do not believe that that level would be sustained, nor do I believe that the additional advantage of the £3.8 billion of expenditure on public services in Scotland, which we enjoy, would continue.

Mr. Salmond: Does the Secretary of State accept that, even using his Department's methodology, and allowing

for Scotland's share of UK public borrowing and, of course, our share of our own natural resources, the fiscal surplus of Scotland in the past 17 years amounts to £80 billion, or £16,000 a head for every man, woman and child in the country? Can we arrange a seminar at which those facts could be explained to hon. Members such as the hon. Member for Isle of Wight (Mr. Field), which is seeking independence I understand, so that they can answer this simple question: if they really think that Scotland is subsidised, why are they so anxious to hang on to us?

Mr. Forsyth: Because, unlike the hon. Gentleman, we are Unionists and because we place the interests of our country before narrow nationalism, which would impoverish Scotland and damage our public services. The hon. Gentleman is on to an idea, however. We should have a seminar, and he and the hon. Members for Hamilton (Mr. Robertson) and for Orkney and Shetland (Mr. Wallace) could come along. We could study Scotland's budget and hear where the Opposition parties' priorities would lie. I would be happy to organise that—let us do it next week.

Mr. McAllion: If expenditure levels are so much higher in Scotland, can the Secretary of State explain why the Government recently allocated £25 million to 13 towns in England to pay for the rough sleepers initiative when not a penny was allocated to any town or city in Scotland? That is an absolute disgrace, especially when we remember that surveys north and south of the border have shown that more people are sleeping rough in one small part of Glasgow city centre than in any of the 13 towns to which the Government handed those millions of pounds. Why does the right hon. Gentleman not fight in the Cabinet for Glasgow and other Scottish towns? If he is not prepared to fight, he should go.

Mr. Forsyth: It is absurd for the hon. Gentleman to compare housing expenditure in England and in Scotland. He should look at what is happening in his city and throughout Scotland—levels of expenditure on housing in Scotland are way above those in England. In so far as we have given—

Mr. McAllion: I asked about the rough sleepers initiative.

Mr. Forsyth: Well, we have put the money into creating homes for people to live in, and we have a record of improvement, refurbishment and creating new housing in Scotland to which no Labour Government could hold a candle.

NHS (Scotland)

Mr. Ernie Ross: To ask the Secretary of State for Scotland when he last met the chairmen of health boards to discuss the current situation of the NHS in Scotland. [3465]

The Minister of State, Scottish Office (Lord James Douglas-Hamilton): I meet chairmen of health boards regularly to discuss matters of current interest.

Mr. Ross: When the Minister of State next meets the chairmen of health boards, does he intend to have the


same discussion as Scottish Office officials recently had with the chief executives of trust hospitals? They impressed on them that they and their trusts should be concerned not about improving the health care of the people for whom they are responsible, but about implementing the promises in the last Tory manifesto up to the next general election.

Lord James Douglas-Hamilton: We are determined to improve the health standards of everyone in Scotland. That was our commitment, and we are going to do it. The chief subject that I discussed with the chairmen of health boards was the need to ensure that contingency arrangements are put in place to meet peaks in demand throughout the winter. It is perfectly proper for a Government to implement the manifesto commitments that they gave the people before a general election.

Mr. Bill Walker: Does my right hon. Friend agree that the current situation in the health service in Scotland is affected substantially by the way in which councils have used health service funds for care in the community? The inspection in Tayside revealed that it was costing more than £200 per head per week to keep individuals in local authority homes and that that was causing bed blocking in the health service, costing many millions of pounds.

Lord James Douglas-Hamilton: My hon. Friend raises a matter of great relevance. The inspection showed that the three authorities could achieve long-term savings totalling between £3 million and £6 million a year by making more use of independent sector care and that local authority homes did not offer better standards of care overall than the independent sector.
Local authorities will in future be required to make available to the public and to councillors full information on the comparative cost to authorities of buying residential care and providing it in council-run homes. It cost the three authorities an average of £200 more per person per week to provide care for an older person in their homes than to buy care from the independent sector. Authorities should comply with the spirit of the directions issued by the Scottish Office, which would be greatly to the benefit of older people in Scotland.

Mr. Canavan: Will the Minister discuss with the chairmen the declining number of national health service beds in certain specialties? For example, is he aware that the Forth Valley health board is planning to reduce the number of NHS beds for frail elderly people to such an extent that, by 2000, there will be a national health service bed for less than 0.6 per cent. of the elderly population?
On psychiatric services, will the Minister comment on the speech made last night by the respected judge, Lady Cosgrove, in which she said that there will be more suicides and murders unless we provide more national health service beds for psychiatric patients who are unable to cope in the community?

Lord James Douglas-Hamilton: I have visited Lochgreen hospital in the hon. Gentleman's constituency; the closure of that hospital will not take place until all the

other packages of care and accommodation are firmly in place. Two new developments in Falkirk, the Carrongrove and ANS nursing homes, are due to be completed by early 1997 and will provide an additional 168 places for the frail and elderly. Extensions to existing nursing homes in Bo'ness, Falkirk and Airth—

Mr. Canavan: That is irrelevant: those are private nursing homes.

Lord James Douglas-Hamilton: This is in the hon. Gentleman's constituency; what happens on his doorstep is extremely relevant. There will be a further 67 places in Bo'ness, Falkirk and Airth, which is more new places than are required to accommodate the patients at Lochgreen hospital. We believe strongly that sufficient places must be made available to meet any peaks in demand, and I have no doubt that the NHS will give priority in future to the most pressing needs.

Sir Irvine Patnick: Does my right hon. Friend prefer the Prime Minister's statement that he will increase national health spending above the rate of inflation year on year to the way in which the Opposition parties would plunder the funds to pay for their excesses, with more councillors and more of the things that they deem to be needed?

Lord James Douglas-Hamilton: My hon. Friend is absolutely right. We have given a commitment to increase national health service funding year on year in real terms. The official Opposition have failed to match that, and the hon. Member for Falkirk, West (Mr. Canavan) is very welcome to take the matter up with his Front-Bench colleagues, who have not given as strong a commitment to the national health service as we have.

Mr. Chisholm: Have not the Government any sense of shame or constitutional propriety? They try to involve top civil servants and health service managers in promoting Tory party policy, and blame Labour local authorities for the bed blocking that Government policy has caused. The Government are behaving in a desperate and improper fashion, while waiting lists are at record levels, beds are being closed in spite of the looming winter bed crisis, £170 million has been spent each year on the bureaucracy of the internal market in Scotland and two-tierism is undermining the fundamental principles of the NHS—with the open support of the Minister as expressed earlier this month. Is it any wonder that people all over Scotland are saying, with sadness and anger, that enough is enough?

Lord James Douglas-Hamilton: It will not do for the hon. Gentleman to throw mud at the national health service. I have not the slightest doubt that it is the best in the world and we are determined that it should remain so. It now treats far more patients and has far shorter waiting lists. The inspectors operate independently; the facts that accompanied their very thorough report cannot be denied. If certain people do not like that, it is because they do not necessarily like having to be efficient, but efficiency is in the best interests of patient care.

Non-custodial Penalties

Mr. Clifton-Brown: To ask the Secretary of State for Scotland if he will make a statement about the introduction of more severe non-custodial penalties for convicted offenders.[3466]

Mr. Michael Forsyth: We have made it possible for community service orders to be longer and tougher, and we shall introduce electronic tagging, subject to the House approving the necessary legislation.

Mr. Clifton-Brown: I congratulate my right hon. Friend on the latter point. Has he noted the inconsistency between Labour's Front-Bench Scottish spokesmen, who oppose these proposals, and its senior Front-Bench spokesmen south of the border, who purport to be tough on crime and tough on the causes of crime?

Mr. Forsyth: I have noticed a certain inconsistency, which I assume is due to the length of the line of communication from Islington. It is extraordinary that the hon. Member for Blackburn (Mr. Straw) should suggest that the Labour party wants to decide the bedtime of the nation's children, while the hon. Member for Hamilton (Mr. Robertson) continues to oppose our proposals for electronic tagging, which is a useful way of dealing with football hooligans and others who cause disturbances on the streets of our towns and cities, especially on weekends and Friday evenings.

Mr. Galbraith: Why does the Secretary of State always talk tough on crime but act so weakly on handgun control? Why has he left a glaring loophole through which people can retain ownership of .22 handguns? Does he not realise that the people of Scotland are outraged? That is unfinished business and the next Labour Government will legislate to abolish all handguns.

Mr. Forsyth: I do not think that there is going to be another Labour Government. If there is, they will presumably be better at getting their people to turn up than the Labour Opposition have been. I am sure that the hon. Gentleman did not want to mislead the House, but people will not be able to have handguns of any calibre outside registered gun clubs. I have made it absolutely clear that the toughest standards of security will be applied. The hon. Member for Hartlepool (Mr. Mandelson) was among those who voted for the handgun ban, but only weeks before the vote he assured his constituents that Labour's policy was to allow people to continue to use handguns in clubs. It is impossible not to conclude that Labour has sought to exploit the issue for party political purposes. I think that that is disgraceful.

Mr. Waterson: Does my right hon. Friend agree that tougher sentences, whether custodial or non-custodial, are overwhelmingly popular with the law-abiding public and that the only people who are out of step on the issue are Opposition Members and a few misguided senior judges?

Mr. Forsyth: I would never criticise the judges. It is for the judges to implement the law and to exercise their judgment in doing so in the courts; it is for Parliament to decide what the law should be. I observe only that on every measure, and perhaps most spectacularly on our

proposals to allow a right of appeal by the Crown against lenient sentences imposed by judges, the Opposition have voted against the interests of those who want the country to be seen to be tough on crime and to give the judges the powers that they need to ensure that the punishment fits the crime.

Mr. Davidson: Does the Minister accept that it is not only the toughness, but the certainty, of the sentence that acts as a deterrent? Is he, like me, concerned about delays between the date of an individual being charged by the police and the date on which he or she is to appear in court? Delay undermines the system's credibility if people who are known to have been caught and charged by the police are free to continue offending until they appear in court. Will the Secretary of State publish the figures for delays between charging and sentencing? Will he undertake to do something about those delays?

Mr. Forsyth: I agree with the hon. Gentleman: there are unacceptable delays in the system. The legal aid system partly encourages delay, which is one reason why we want to reform it. The hon. Gentleman is right to mention the importance of the punishment being administered as soon as possible and to say that people who have committed serious crimes should not be allowed to be released into the community. We have been concerned about bail. I shall certainly consider the hon. Gentleman's suggestion about publishing the length of the delays. I got into some trouble with, and encountered opposition from, the hon. Gentleman's colleagues when I said that we would publish the sentencing practices of the sheriff courts—there are inexplicable and wide variations between them. The hon. Gentleman pinpoints a matter that causes considerable concern in communities the length and breadth of Scotland.

Mr. George Robertson: We are prepared to consider and assist on non-custodial penalties in the Scottish legal system where they are appropriate. The Government's reputation and credibility on law and order was seriously damaged on Monday night when they politicised the handgun issue with a whipped vote in the House. Has the Secretary of State read in today's paper the comments of the dean of the Faculty of Advocates—Scotland's top QC—who says that, in the general fight against crime in Scotland, a total ban on handguns is appropriate and necessary? There is still time to reconsider the Firearms (Amendment) Bill before it becomes the law of the land. Is it not possible for the Government to try to rescue their reputation by allowing Conservative Members to follow their judgment and conscience rather than the diktat of the Whips Office?

Mr. Forsyth: My right hon. Friend the Prime Minister and the Cabinet reached a view on handguns that went way beyond Lord Cullen's recommendations and what Opposition parties were saying prior to knowing the Government's views. If I believed that a ban on handguns was the right policy for my party—I understand that that is the hon. Gentleman's position—I would do everything possible to ensure that there was a whipped vote to achieve that end. The hon. Gentleman could not even get his colleagues into the Lobby to support his party's policy. My right hon. Friend the Prime Minister's colleagues were in the Lobby supporting a policy that


went way beyond what the hon. Gentleman was prepared to describe as his policy until he knew what the Government were going to do.

Health Service Reforms

Mr. Malcolm Bruce: To ask the Secretary of State for Scotland when he next plans to meet the chairman of Grampian health board to discuss health service reforms. [3467]

Lord James Douglas-Hamilton: I meet all health board chairmen regularly to discuss all matters of current interest.

Mr. Bruce: When the Minister next meets the chairman of Grampian health board, will he tell him from me that there is considerable welcome for one development in recent years: the growing role of community hospitals across Grampian region? The Minister will soon receive an application for the upgrading of Inverurie community hospital, whose GPs are total fundholders. As the Minister has already agreed to the upgrading of Peterhead and Turriff hospitals, which have total fundholding practices, will he give a positive response to the application from Inverurie, which is an important community hospital in the heart of my constituency?

Lord James Douglas-Hamilton: The health board is currently considering proposals for investment in Inverurie hospital by the Grampian Health Care NHS trust. The board has not reached any final decisions on the purchasing requirements, but I shall certainly draw the hon. Gentleman's comments to its attention.

Mr. Watson: When the Minister meets the Grampian health board chairman, will he discuss the problems associated with the private finance initiative which, as a result of health service reforms, is virtually the only source of capital projects in the health service in Scotland? Will he draw to the chairman's attention the difficulties associated with the Victoria infirmary in my constituency, where no funding short of that initiative is available? Will he clarify the attitude of the Scottish Office, which was previously so enthusiastic about the PFI, to the Treasury Committee's report on the initiative early this year? That report said that £3 billion of potential spending in Scotland was at risk owing to private companies using the PFI to boost their own profits rather than serving the public good. Will he give a commitment that the health service in Scotland will be funded on the basis of what people, not private companies, need?

Lord James Douglas-Hamilton: That goes without saying, but I can say that the private finance initiative will greatly increase resources for the NHS and make public sector funds go much further. We are taking forward a wide range of different projects, including the one to which the hon. Gentleman referred. We have had great success with some smaller projects. For example, Ferryfield in Edinburgh is a small project, but it saves the health board £100,000 a year, which is to the board's great benefit. We believe that, gradually, the sums will run into many millions of pounds—some

£70 million has already been committed to PFI projects—and that, before many years have passed, they will be hundreds of millions and eventually thousands of millions. However, the plans must first be put firmly in place and they must add up and balance. We must be certain that they will provide the required outcome. Every detail has to be thought through to its final conclusion.

Government Expenditure

Mr. Stephen: To ask the Secretary of State for Scotland what was total Government expenditure in Scotland as a percentage of the United Kingdom total in 1994–95; and what was Scotland's relative share. [3468]

Mr. Michael Forsyth: Scotland had 8.8 per cent. of the UK population and received 10.2 per cent. of funding in 1994–95.

Mr. Stephen: Do not those figures show that the people of Scotland are getting an extremely good deal from this Conservative Government? Is it not time that Scottish Opposition Members stopped their ritual moaning and groaning and acknowledged the enormous benefits that membership of the United Kingdom provides to their constituents?

Mr. Forsyth: The people of England are getting a very good deal from Scotland being part of the United Kingdom. My hon. Friend is right to point out that there is a substantial financial benefit to Scotland from the present constitutional arrangements which, with that substantial funding, all the Opposition parties would put in jeopardy. Given the size of the additional funding that we enjoy, tampering with it would put at risk many vulnerable groups who depend on health care and local government and other services.

Mr. Foulkes: Is the Secretary of State aware that that budget includes £13 million of capital expenditure for the East Ayrshire hospital? Why has he not given that project the go-ahead? Why has he delayed it for two months so that a private finance initiative bid can be considered? Why has he continued to delay while that private finance initiative bid is allowed to be adjusted? Something fishy is going on—what is it?

Mr. Forsyth: What is going on is that we are trying to provide a hospital for the hon. Gentleman's constituents. I am sorry that he is so concerned that we are doing everything we can to bring in private finance so that more projects can go ahead in the health service in Scotland—on which we have a record of which we are proud.

Mr. Stewart: Does my right hon. Friend agree that one of his biggest blocks of expenditure in Scotland is local authority expenditure? Why is local authority expenditure in Scotland so much greater than that in England or Wales?

Mr. Forsyth: Because we have so many more Labour councils and because of the waste and profligacy in local government that has to be seen to be believed. The additional grant is necessary because those Labour councils are so bad at collecting council tax. Uncollected


council tax and community charge adds up to three quarters of a billion pounds—money that could be used for front-line services. It is money that Labour councils, in the main, have refused to collect.

Mr. Macdonald: Does the Secretary of State agree that Government expenditure in Scotland will inevitably have to increase if the salmon industry collapses, with the loss of thousands of jobs? Will he confirm that he favours a minimum import price, but that he has been overruled by the Treasury and the Chancellor, who prefer the purity of free market ideology to protecting Scotland's jobs?

Mr. Forsyth: The hon. Gentleman usually accuses me of being the supporter of free market ideology. [Interruption.] This is a serious issue. The farmed salmon industry is vital to Scotland. Many thousands of jobs depend on it.
The salmon price has fallen dramatically. One way to deal with the matter in the short term is to ask the Community to introduce a minimum import price. In the longer term, we need to tackle the root of the problem—Norwegian dumping into the market. The Commission is at present investigating those matters with a view to reporting in early spring.
I know the hon. Gentleman's anxieties about the matter. I am in discussion with my colleagues about it. I will continue that discussion in the hope of being as supportive as I can to the industry, which is vital to the highlands and to the hon. Gentleman's constituency in the islands.

Local Government Finance

Mr. David Marshall: To ask the Secretary of State for Scotland when he next intends to meet the Convention of Scottish Local Authorities to discuss local government finances. [3469]

Mr. Kynoch: The next meeting is scheduled for 17 January.

Mr. Marshall: Does the Minister agree that the present formula for distributing revenue support grant takes little or no account of the costs, services and needs associated with business communities in city areas? Is he aware that Glasgow city council collects slightly more than £200 million per annum in non-domestic rates but receives slightly more than £150 million in return—a loss of £50 million per annum to the city? What does the Minister intend to do about such blatant discrimination against the major cities in Scotland?

Mr. Kynoch: The hon. Gentleman is only too well aware that the distribution of funds to local authorities in Scotland is discussed at the distribution committee of the Scottish Office and COSLA. The formulae used for that distribution have been in place since 1985, and are discussed and fine tuned each year. I suggest that the hon. Gentleman asks the City of Glasgow why it still has not collected about £200 million of community charge and council tax. If it did, that might solve its problems more quickly.

Mr. Norman Hogg: Is it not the case that the Government already know what next year's local

government funding will be? Is the Minister not aware of the grave situation that was created for local government last year, which placed very many services in danger and put cultural activities at risk? Will the Minister give an assurance that nothing like that will happen this year, that the settlement will not be used for electioneering purposes and that local government will not be asked to bear the cost of cuts designed to assist the Government's other tax strategies?

Mr. Kynoch: I am sure that the hon. Gentleman is aware that, last year, an increase of about 3.6 per cent. was given to local authorities throughout Scotland from central taxation. That enabled most authorities to increase their budget by a minimum of 3 per cent. over the previous year; some were able to increase it by 4 per cent.
The hon. Gentleman should address his comments to Labour councillors on his local council and ensure that they obtain the best value for money for their council tax payers so that more services are provided at better value. At present, they do not even know how many people they employ, as was witnessed by the joint staffing watch survey carried out jointly with COSLA. I believe that we shall continue to treat local authorities fairly throughout Scotland, provided that they act responsibly on behalf of taxpayers.

Government Expenditure

Mr. David Evans: To ask the Secretary of State for Scotland what is the current total Government expenditure per capita in Scotland. [3470]

Mr. Michael Forsyth: Identifiable expenditure per head was £4,505 in Scotland—about 25 per cent. higher than in England.

Mr. Evans: If that lot over there get their way on devolution, will us English stop subsidising their way of life? When the tartan tax takes over, will we police Hadrian's wall to stop the marauding Scots coming into England, which will by then be a tax haven—so they will all want to come here? Furthermore, if we have devolution, can my right hon. Friend assure me that Scottish Members of Parliament will have no authority in this House at all?

Mr. Forsyth: I think that is a fair summary of the arguments against the Labour party's case for a tax-raising Parliament. My hon. Friend put it very eloquently.

Mr. McFall: Can the Secretary of State explain why a formula that is widely seen to be fair by all United Kingdom parties should now be seen as unfair in the context of a Scottish Parliament? In a country where, after 17 years of Conservative rule, one in five households have no one in work, as many as 1 million elderly people are paying the penalty of the Tory VAT increases on heating, and thousands of young people are leaving school for a no-hope jobless future, does the right hon. Gentleman agree that it is nothing less than shameful that a politically vacuous, illiterate and ignorant English Back Bencher should suggest that we in Scotland cannot manage our expenditure with a Scottish Parliament?

Mr. Forsyth: I dare say my hon. Friend the Member for Welwyn Hatfield (Mr. Evans) has done more for wealth


creation than has the hon. Gentleman. If he is puzzled as to why the formula would no longer continue, the answer is that he cannot expect this House to continue to vote 25 per cent. more money for the Scots than for hon. Members' own constituents in England if the hon. Gentleman and his party have their way and there is a tax-raising Parliament in

Scotland. It is because the hon. Gentleman and his party wish to gerrymander our constitution that they place that funding at risk. The people who would suffer would not be the hon. Gentleman and his cronies in the Labour party; it would be the honourable, ordinary people of Scotland who would find their services jeopardised.

Zaire

Dr. John Reid(by private notice): To ask the Minister of State for the Armed Forces if he will make a statement on the plans for the deployment of British forces to Zaire.

The Minister of State for the Armed Forces (Mr. Nicholas Soames): The House will recall the statement made last Thursday by my right hon. Friend the Secretary of State for Defence. At that time, fighting in eastern Zaire was reported to have intensified. There were estimates that hundreds of thousands of refugees were at risk, and that the death toll was likely to escalate rapidly.
In the face of a potential humanitarian tragedy, my right hon. Friend made it plain that the United Kingdom was ready to play its part in the temporary multinational force for which United Nations Security Council resolution 1078 had called. But he also emphasised the absolute necessity to establish clear objectives for any force dispatched to the region, and announced that we had authorised a reconnaissance party led by Brigadier Jonathan Thomson, the chief of joint rapid deployment force operations, to travel to Zaire to establish in greater detail what the situation was on the ground. The House will wish to be aware that the party was vastly assisted by Her Majesty's ambassador to Rwanda, Miss Kay Oliver, and her team, who have done a remarkable job in the past few days and deserve great credit.
The recce party made its report yesterday. It confirmed that the return of refugees from north Kivu to Rwanda was largely complete and that the situation in the area around Goma had therefore eased substantially.
It is possible that last week's decision to mount a multinational force was instrumental in persuading the Hutu militia to flee and the refugees to return home. By contrast, the position in the area to the south of Lake Kivu remains confused and complex. The precise whereabouts and condition of a large number of refugees are unclear. There remains a critical shortage of information on what is happening in the south Kivu region, which makes it extremely difficult for military planners and humanitarian agencies alike to assess what action is needed; although it is clear in any event that humanitarian support will be needed in Rwanda as refugees return to their homes.
The House should know that my right hon. Friend has authorised the deployment of a Canberra photo-reconnaissance aircraft with its attendant support to the area, to assist in establishing a clearer picture. Until we have more detailed information, we shall be in no position to take sensible decisions on how best to help.
In the mean time, we are continuing to plan a range of options with our potential partners in a multinational force. We also continue to keep in close touch with the humanitarian agencies and we are monitoring the situation closely as it develops. My noble Friend the Minister for Overseas Development has announced this afternoon that a further £10 million will be provided to help to meet needs in Rwanda and the great lakes region. That brings our total contribution for Rwanda and its refugees to more than £18 million in 1996.
The option of deploying a multinational force to south Kivu remains open. My right hon. Friend the Secretary of State made it clear last week that the Government were ready to take prompt and effective action to help to overcome the crisis. That remains the case.
In the light of the changed circumstances, we are urgently assessing the direction of events and consulting our partners further before final decisions are taken. The House will, I know, understand and agree, and will wish to be reassured that we are making absolutely certain that any contribution, whether military, political or in the form of aid, properly meets the needs of the people in the region.

Dr. Reid: I thank the Minister and welcome the additional £10 million that has been made available. Like the entire House, I welcome the fact that hundreds of thousands of refugees have now reached comparative, albeit temporary, safety.
We recognise the fluidity of the situation. The nature of the deployment of any British troops may have to be subject to revision in the light of the professional evaluation of the reconnaissance party.
We welcome the Government's efforts to enhance our information-gathering capability by sending a Canberra aircraft to assess the situation.
When does the Minister expect to be able to give a detailed response to the findings of the recce party? Does he recognise that hundreds of thousands of refugees are still stranded in eastern Zaire and that it is not clear what the Hutu militias are planning—possibly a regrouping and reinforcement of their positions?
Can the Minister confirm reports that members of the British team sent to eastern Zaire were unable to visit parts of the area that they wished to see because they were barred by the Hutu militia, and that they had to make observations instead from the high ground in Rwanda? Does he accept that there remain formidable problems of logistics and organisation, even for the refugees who have reached comparative safety, and that those are problems for which military skills and logistical operations may be of great assistance?
Although we appreciate that the situation is fluid, I am sure that the House would be grateful if the Minister told us his current thinking about the number of troops to be sent. In that context, what are the implications for Britain of America's announcement that it is to send fewer than 1,000 support troops? What communications has he had with our western allies in assessing the situation?
Finally, will the Minister accept the Opposition's assurance that we remain supportive in principle, should the decision be taken to deploy our troops in the light of the reconnaissance report? We ask, however, for an assurance that any final decision will be subject to a fuller statement from the Minister, so that the House can examine the details of the mission objectives, command structures and any rules of engagement that might be appropriate.

Mr. Soames: I am very grateful to the hon. Gentleman for his remarks and for his support throughout.
The hon. Gentleman asked about the reconnaissance party. I can confirm that members of the reconnaissance party were well received wherever they went and that they were able to make assessments on the ground and see all that they needed to see. They did not have any trouble of the kind that the hon. Gentleman feared. They could see from where they were all that they needed to see. They have made a full and detailed report to my right hon. Friend the Secretary of State and to Ministers and the chiefs.
The hon. Gentleman's point about logistics and the difficulty of delivering aid is well taken. Clearly, if a force of any size were deployed under the present circumstances, one of the principal requirements would be the ability to deliver aid and to resolve the associated logistical problems.
The hon. Gentleman asked about our current thinking on the number of troops. That depends on our assessment of the situation and our absolute requirement to clarify the situation on the ground, but it seems that the problem is not as serious as we originally thought. The House will realise that although the position in the north is considerably eased, there is no such assurance about conditions in the south. We are anxiously seeking information about those refugees.
The hon. Gentleman will realise that the liaison between our western allies and the United States is extremely close and on-going. A team from our permanent joint headquarters will deploy to Stuttgart, to EUCOM, for the planning meeting that starts tomorrow, and I hope that we shall, towards the end of the week, have a clearer idea of the situation on the ground and of the configuration of forces that we shall need. I reassure the House, as my right hon. Friend the Secretary of State did last week, that there will be no question of going without a clear mission, proper command and control and everything else about which the House expressed concern.

Mr. Michael Colvin: Most people will acknowledge that the Ministry of Defence has responded to a very complex and confused situation in eastern Zaire and Rwanda with commendable clarity and resolve, unlike some other countries. It is just as well that our new joint rapid deployment force was operational and not committed elsewhere.
We also applaud the readiness with which 10 African states have come forward to volunteer troops to a combined joint task force. Should not we be giving African countries and, perhaps, countries in other continents, help in setting up planning cells and command structures, so that if such emergencies arise again, as they are bound to do, at least they will be able to help themselves rather than being forced to rely on outside help, no matter how ready other countries are to assist?

Mr. Soames: I am grateful to my hon. Friend. I think that the House will agree that Her Majesty's Government responded as one would expect them to in the circumstances of impending potential humanitarian catastrophe, by taking steps to ensure that Britain would be able to make its rightful contribution. It is lucky that the JRDF was not deployed elsewhere. It has also turned out to be an extraordinary stroke of good fortune that it was up and configured. The new permanent joint headquarters has played a notable role in the planning of the operation.
I wholly endorse what my hon. Friend said about African countries and peacekeeping operations. As he knows, Britain has had a number of short-term training teams deployed in Africa over time. They have played a notable role. Indeed, Britain played a great role in the conference on peacekeeping in Africa, in Zimbabwe, last year. I agree that African countries need to be able to play a bigger part in resolving their own difficulties, which would be greatly to their advantage.

Sir David Steel: May I, on behalf of my colleagues, give a wholehearted

welcome to the Minister's statement? I remind him that two years ago I visited British troops who were in Kigali as part of the UN force, and General Dalliaire, who was in charge of the UN operation—indeed everybody—said that if only the international community had been able to send troops three months earlier, we might have been able to have a police operation, which would have prevented the exodus of refugees into Zaire.
Learning from that experience, will the Minister emphasise the part of his statement where he talked about liaising with humanitarian agencies? Does he also recognise that we may never get a perfect military plan, because if we wait for that, we shall wait for ever? Will he therefore respond to the cries for help if a police operation needs to be mounted?

Mr. Soames: The right hon. Gentleman makes a good point. There is clearly no point sitting around just waiting for things to happen, because there is no such thing as the perfect military plan. There will always be a degree of risk. I accept, as will everyone in the Ministry of Defence, what the right hon. Gentleman said. Timing is extremely important. There are lessons that we learn after each deployment, and the one raised by the right hon. Gentleman is one such.
However, it is plain that it would be unwise to send troops into a situation such as that which appears to be developing in Zaire and elsewhere without a clear exposition of exactly where the problem is. A week ago, we were looking at sending troops on a basis that it now seems will not be required. It is important that we assess properly the scale and shape of what we need, and then we shall be ready to go at short notice. Indeed, I can confirm to the House that all the troops placed on a shorter notice to move by my right hon. Friend the Secretary of State earlier in the week remain on that short notice.

Mr. James Couchman: This time last week, a delegation from the House was at the United Nations and we were able to watch the informal meeting of permanent representatives of the Security Council discuss the matter in some depth. I pay tribute to our permanent representative, Sir John Weston, who played a leading part in the resolution passed by the United Nations Security Council last week.
Everyone is tremendously relieved that it has not proved necessary to send the sort of force envisaged in the resolution and that many refugees have now returned to Rwanda. Does my hon. Friend foresee the possibility of sending troops to Rwanda—obviously with that country's blessing—to assist with humanitarian and reconstruction work? I think particularly of the Royal Engineers which, as my hon. Friend knows, has a major establishment in my constituency.

Mr. Soames: I am grateful to my hon. Friend and I am glad that he was at the United Nations when those matters were discussed. He will know—as should the House—of the formidable job done by Sir John Weston and his team on our behalf at the United Nations. My hon. Friend is right: if it came to providing purely humanitarian assistance in Rwanda, the Royal Engineers might play an important role, as could the logisticians. I pay tribute to the Royal Engineers, whose home base is in my hon.


Friend's constituency. They are deployed throughout the world and are extremely overworked. I do not know where we would be without them.

Mr. Tam Dalyell: The Canadians offered to take the lead in the mission, but do they remain as enthusiastic as they were? What has President Bizimungu of Rwanda said to the British Government or to Ambassador Kay Oliver? Would he welcome such forces?

Mr. Soames: I am grateful to the hon. Gentleman for the interest that he has shown in the matter and for the courteous way in which he has kept in touch with my office. He is right to ask whether troops would be welcome, as plainly we will not invade the place. We are talking about a humanitarian operation and it is important that British and multinational troops are welcomed wherever they go, with a view to carrying out the mission for which they were sent.
The hon. Gentleman knows that both the Americans and the Canadians are now reassessing—as we are—the need for the kind of deployment that we considered before the vast exodus took place from the north. That plainly changes the situation. I know that the hon. Gentleman would not want us to move without careful thought and assessment of the situation on the ground, so that we go in, first, welcome and, secondly, able and configured to do the job required to save lives. We must not get caught in some awful mix-up.

Mr. John Townend: I welcome my hon. Friend's undertaking that we will not deploy troops without the approval of the Governments concerned. That is a great relief.
Does my hon. Friend accept that the Secretary of State's statement to the House last week was based on incorrect information? Clearly, 20,000 refugees were not dying every day or every week—many of them would have been left in the camps if that were the case. Will he assure the House that in future he will take less notice of scare stories circulated in the media, by aid agencies or by others with a vested interest?

Mr. Soames: My hon. Friend should recall the exact remarks of my right hon. Friend the Secretary of State, who said that refugees in the northern part of the country could be the victims of a potential humanitarian catastrophe. Her Majesty's Government received that information not just from the non-governmental organisations but from the United Nations High Commissioner for Refugees. The information was substantiated by our sources and it was clear then that the British Government and other Governments of the civilised world should prepare to take part in a relief operation. It would be a shameful thing for Britain, among all countries, even to contemplate standing apart if something terrible happened.

Mr. John Home Robertson: Unlike the hon. Member for Bridlington (Mr. Townend), I welcome wholeheartedly the fact that the British Government are willing to take part in another United Nations-sponsored humanitarian operation. I fear that such a scenario will occur time and again in this

increasingly unstable world. Is the Minister aware that our scaled-down armed forces are already seriously overstretched, with commitments in Northern Ireland, Bosnia and elsewhere? Is it not the responsibility of the Government and of the House to give our armed forces sufficient resources and manpower for the task that we want them to undertake?

Mr. Soames: I am probably more aware than anyone in the House of how busy our armed forces are, and I agree with the hon. Gentleman's sentiment, although it was rather intemperately expressed. I know that his heart is in the right place: he is a keen member of the armed forces parliamentary scheme. I assure him that whatever such an operation may have required, and however busy our forces may have been—they are busy at present—that would not have prevented us from conducting the proposed operation.
An overstretch undoubtedly exists, but it was not a factor in this operation. The joint rapid deployment force was created to hold troops available for such operations, so that they could go rapidly wherever we need them, either to defend our interests or to help other people.

Mr. Richard Alexander: The House will welcome the increased aid for refugee women and children. What assurance can my hon. Friend give us that that aid will not be used to feed warring fighters, whose side may not be doing so well? Is there not evidence from the pictures that we have seen that many of the young men among the refugees are former fighters who, refreshed by overseas aid, can carry on fighting at the next opportunity?

Mr. Soames: It is difficult to discriminate in the television pictures between one person and another as they trudge from point A to point B. I am sure that some of the guilty are among those people. That does not alter the fact that we are beholden to help where we can. I hope that the House will agree that we should add this new money to the already substantial help that we are giving to Rwanda. Of the new £10 million commitment, £1.25 million has already been allocated to the World Food Programme. the International Committee of the Red Cross and the British non-governmental organisations to address immediate needs in eastern Zaire and Rwanda.
However critical people are of overseas aid—there are legitimate arguments for and against—the House should recognise that the Overseas Development Administration in this country has a golden and shining record. Our aid is outstandingly well spent in every respect.

Mr. Ieuan Wyn Jones: I am sure that the Minister spoke for the whole House when he said that our first priority was to deliver humanitarian aid to refugees, to help them to return home. He referred to the difficulties of sending troops to Zaire. I am sure that he will agree that the humanitarian aid agencies are heroically delivering services under difficult circumstances. Until the Minister is able to make a statement on the deployment of troops, what practical assistance can the Government offer those agencies, to ensure that the aid gets through?

Mr. Soames: I am grateful to the hon. Gentleman for those words, and I join him in his warm tribute to the humanitarian agencies. They do so much all over the


world, not just in times of crisis when they are on everyone's television screens, but every day when they help people in desperate circumstances.
Until we have people on the ground, the Government are plainly not able to assist in dispatching aid. I am sure that aid agencies will warmly welcome the announcement that I made this afternoon and which my noble Friend Baroness Chalker, the Minister for Overseas Development, made on additional aid to humanitarian agencies.

Mr. John Wilkinson: I thank my hon. Friend for his judicious and reassuring statement. He has forgotten none of the lessons of his formative military years, that time spent in reconnaissance is never wasted. Can he reassure the House that there will be no diminution of the Royal Air Force's aerial reconnaissance capability, which is so important in this emergency, because it enables us to assess need over huge areas of ground and extremities of range? On the logistics of the emergency, can he tell us whether the Government comprehend the RAF's requirement for a heavy lift capability, such as the C17 aircraft, which can carry huge amounts of kit at rapid speeds to any emergency hot spot around the globe?

Mr. Soames: I am grateful to my hon. Friend for what he said. He is right about the age-old adage in volume 1 of "Staff Duties in the Field", which tells us that time spent on reconnaissance is never wasted: that is critical.
I can confirm that deployment of the Canberra PR9 will not affect the Royal Air Force's reconnaissance efforts elsewhere. As for heavy lift, my hon. Friend is right in saying that it remains an important question for the joint rapid deployment force. I shall draw what he has said to the attention of my right hon. Friend the Secretary of State, and I hope that he will continue to raise that serious and important issue.

Mr. Mike Gapes: The Minister referred to the situation around the south of Lake Kivu. Will he confirm that there are refugees there who have come from Burundi? Will he also confirm that the crisis has led to the displacement of many thousands of Zaireans? Although it is welcome that hundreds of thousands of people have returned to Rwanda, the geography and the complexities are such that there is still a crisis affecting hundreds of thousands of people. The problem has not been solved yet.
Will the Minister also confirm that some of the £10 million of aid that has been announced will be used to assist long-term reconstruction in Rwanda, allowing the possibility of stability, democracy and respect for human rights?

Mr. Soames: I entirely agree with the hon. Gentleman that the crisis is not over yet. He is right to point out that, around Lake Kivu and in the south, there remain possibly a vast number of refugees of whose exact whereabouts and condition we know little. We need to establish those facts. The hon. Gentleman is also right in saying that there are people from Burundi there: that complicates the matter further.
As for the £10 million of aid money, and the hon. Gentleman's desire for it to be deployed in reconstruction, that is a matter for my noble Friend the Minister for Overseas Development. I agree, however, that

reconstruction, and stability for the people of Rwanda, will be a great prize for those people, and—we hope—will prevent further trouble of this kind.

Mr. Bill Walker: My hon. Friend and his colleagues at the Ministry of Defence are to be congratulated on the way in which they have handled the problem. It is true that the ability of fixed-wing aircraft to be deployed for intelligence gathering and reconnaissance is a vital part of any operation; it is also true that command and control is a vital part of any operation. Many will advise my hon. Friend to encourage African nations to become much more involved, and we welcome their involvement, but what we must never do is commit United Kingdom troops when we are not satisfied that command and control has the experience and expertise to do the job properly.

Mr. Soames: My hon. Friend is right about the importance of photo-reconnaissance. The Canberra PR9 in particular has proved extraordinarily valuable, and has served us for many years. I also endorse his views on command and control. Any follow-on force along the lines that we originally considered would, we hope, largely consist of a number of African nations that have themselves volunteered to take part. We would never involve our own forces—even if we take the point made by the right hon. Member for Tweeddale, Ettrick and Lauderdale (Sir D. Steel) about waiting until it is too late—unless we were absolutely satisfied about command and control.

Mr. Robert N. Wareing: I fully support what is now being proposed in regard to humanitarian assistance, but is there not a moral in all this for future defence and foreign policy? On 15 January, in two replies to questions from me, the Minister said that, between 1991 and 1995, this country had provided military assistance for the armies of Rwanda and Zaire. Does that not demonstrate that we should be rather more constrained in choosing the regimes that we provide with training and, in particular, arms?

Mr. Soames: I think that the hon. Gentleman is confused, in his penetrating questioning of me, as between United Nations assistance in Rwanda and assistance elsewhere, but on the more general point, clearly, I agree with him. We are extremely careful and cautious about where we provide military training. British military training teams in South Africa and elsewhere have done a great deal. The House will wish to pay tribute to the work, for example, of the British military training team in South Africa. The team has done so much to help to assimilate all parts of the South African army. On the more general point outside Zaire and Rwanda, I accept what the hon. Gentleman says. We need to be extraordinarily cautious, and we are.

Mr. Jacques Arnold: Bearing in mind the fact that British forces had no operational experience in any of those three countries during colonial times or


since, can we nevertheless be wary of taking advice from the French, who have such experience, but who have such a colourful and partisan record in those countries?

Mr. Soames: I know that my hon. Friend is seeking to be helpful, but British forces have been engaged in both Rwanda and Angola within the past 18 months.

Mr. D. N. Campbell-Savours: What is the Government's estimate of the total number of Hutu refugees still in Zaire? What are the Government going to do about a British arms trading company that supplied arms to the region, which was clearly a major component in the strife that is taking place and which may have been in default of UK legislation?

Mr. Soames: The hon. Gentleman asked me first about the number of Hutus remaining. The answer is that we simply do not know. That is one of the reasons why we need to have further and better particulars before we become more heavily engaged.
As to the second point, as the hon. Gentleman knows, the Government have been extremely concerned to learn of allegations that UK companies might have been involved in the supply of arms to Rwandan extremists. The Government have well-established and strict procedures to ensure that any UK arms exports are both responsible and legitimate. There is no allegation that the arms have been exported from the UK, but Her Majesty's Customs and Excise is urgently investigating the matter to establish whether any offence has been committed under UK law.

Mr. Hugh Bayley: May I return to the point that I put to the Secretary of State for Defence last Thursday, which follows on from the question that the Minister has just answered? Does he agree that the long-term peace and stability of a region depends on getting arms out of the hands of militias, and that, both in the UK and internationally, further work is needed to identify the sources of those arms and to ensure that those sources are stopped off?

Mr. Soames: As the hon. Gentleman knows, the reasons for the instability in the region go much more widely than the narrow point that he raised. Plainly, as I said, we have strict rules on arms sales. As to the general and wider point of arms sales to irresponsible countries, plainly, everyone would share the hon. Gentleman's view that that is undesirable. He needs to consider more points than just arms sales as the reason for instability between Zaire and Rwanda.

Points of Order

Sir Terence Higgins: On a point of order, Madam Speaker. May I draw to your attention the front page and page 2 of The Guardian today, where there appears a report that purports to record what has taken place in the Select Committee on Standards and Privileges? The best way of handling this may be for the Select Committees concerned to deal with it in the usual way and undertake a leak inquiry. None the less, the matter is obviously of considerable importance and, although fortunately there have been few leaks from Select Committees recently, any leak casts into doubt the integrity of the Select Committee system, especially perhaps in relation to that particular Select Committee. Therefore, Madam Speaker, I should be grateful if you will consider whether other action might appropriately be taken.

Madam Speaker: If there has been a leak, I deprecate it most strongly. As the right hon. Gentleman is aware—he has made the point himself—it is, first, for the Committee itself to look into the matter when there appears to have been unauthorised publication of its proceedings. Once the facts are established, the Committee may make proposals for further action. I am sure that, as a result of his point of order, the Committee will look into the matter, but I shall take considerable interest in its activities on it.

Mrs. Ann Taylor: On a different point of order, Madam Speaker. May I draw your attention to the extraordinary events in Committee Room 10 this morning. at the meeting of European Standing Committee B, to discuss documents relating to economic and monetary union? Are you aware, that Committee Room 10, which is one of our largest rooms, was so crowded that not all hon. Members who wanted to participate in the proceedings could find seats? More importantly, are you aware that the Government were defeated on their motion, and that the Committee refused even to take note of the documents before it, because hon. Members felt that those issues warranted a full debate in the Chamber?
Will you confirm, Madam Speaker, that the Government could, were they so unwise, simply table a motion so that the House has to decide the issue on a forthwith basis, and without any further debate? Such action would clearly be against the wishes of many hon. Members on both sides of the House, however, as evidenced by the support for the all-party Select Committee's motion, which is on the Order Paper.
Madam Speaker, you may recall that, when I raised similar issues in the past, the Leader of the House said that he accepted that opportunities should be provided for proper parliamentary debate on those issues. Therefore, I wish to ask you what you might be able to do to protect the rights of hon. Members, when the Government are so obviously trying to stifle debate.

Several hon. Members: rose—

Madam Speaker: Wait just a moment. There is obviously strong feeling in the House about this matter. I am certainly not going to take all the points of order—


because they will become speeches—but I want the flavour of the House on this matter. Therefore, I shall take one or two points of order, so that I am quite aware of what has happened.

Several hon. Members: rose—

Madam Speaker: Just a moment; I select the hon. Members here. Mr. Wilshire.

Mr. David Wilshire: On a point of order, Madam Speaker. I should like to ask you specifically about Standing Order No. 102, and I apologise for giving you only brief notice about this point earlier. The purpose of today's meeting, as I understood it, was to enable the Government to say at the European summit in December, that scrutiny had taken place of the three documents on economic and monetary union.
There were many points of order, and I specifically asked a formal question of the Chairman about the issue of scrutiny. I asked, "Does the fact that the Government have moved the motion equal scrutiny, and what will be the position if this Committee decides not even to take note?" The Chairman ruled that simply moving the motion did not amount to scrutiny. At 1 o'clock, the Committee voted not to take note.
By 2 o'clock, the Government were claiming that the morning's farcical proceedings indeed amounted to scrutiny. Therefore, may we have your ruling on whether scrutiny has taken place, and on whether the House has concluded this business—or does it still hang in the air?

Madam Speaker: I call Mr. Hood, Chairman of the Select Committee on European Legislation.

Mr. Jimmy Hood: On a point of order, Madam Speaker. May I appeal to you to protect the integrity of the House—after the events of the past few days, and of today in Standing Committee B—and of my Select Committee? We do not recommend lightly that debates should take place on the Floor of the House. We did so, however, because of the importance of those three very important documents and our belief that the Standing Committee—with no disrespect to it—could not do justice to the necessary debate. We thought that it was necessary that discussion should take place in the House, and that is what we recommended. It was a unanimous decision of the Committee. I wrote to the Leader of the House on 6 November expressing our strong views, and he replied saying that, unfortunately, he could not agree to our wishes. A motion on the Order Paper, which was signed unanimously by members of the Committee, is now supported by more than 150 Members.
Will the Leader of the House give notice in his business statement tomorrow of when a motion will be dealt with, so that the Government cannot just slip it in at short notice late at night? Proper notice should be given, so that the House has a chance to retrieve its integrity.

Mr. Peter Bottomley: Further to that point of order, Madam Speaker. It would be helpful if you could confirm that the situation is not unprecedented, although it would be undesirable to repeat it too often. Perhaps one of the ways forward would be to reach agreement that, at least in the next Parliament if not from now on, matters

will be taken on the Floor of the House when the Select Committee recommends it. Would it not be right to put it on record that the Leader of the House has written to the Chairman of the Scrutiny Committee saying that he intends that the euro, EMU and stability will be debated on the Floor of the House before the Dublin summit?

Mr. Nigel Spearing (Newham, South): Further to the point of order, Madam Speaker. I support the plea of my hon. Friend the Member for Clydesdale (Mr. Hood), the Chairman of the Select Committee on European Legislation.
Is it not a fact that the integrity of the House will not be maintained even if the Government move a motion on the Order Paper and we know the date on which they will, because it will be taken forthwith and there will be no debate? May I ask the Leader of the House, through you, Madam Speaker, whether he can make a business statement on when that motion will be tabled? Do you not feel that the House should consider referring the procedure of taking such matters forthwith to the Select Committee on Procedure? Some time ago, before the Standing Orders were changed, such matters were taken after debate.

Several hon. Members: rose—

Madam Speaker: I am taking no further points of order on that subject. I think that I have the flavour of the House on the matter.

Several hon. Members: rose—

Madam Speaker: No. I must clear this matter up first.
What happened in European Standing Committee B this morning has, I understand, been reported to the House by the Chairman, as laid down in Standing Order No. 102(8). Further proceedings may follow in the House in accordance with the next paragraph of the Standing Order. I do not think that it is necessary or proper for me to say anything else at this stage. It is a matter for the Government to resolve. The Leader of the House will be before us tomorrow to answer business questions— [Interruption.] Order. I shall make further inquiries. I am concerned about maintaining the integrity of the House's procedures.

Mr. David Winnick: rose—

Madam Speaker: Is it a different point of order?

Mr. Winnick: Yes. I wonder, Madam Speaker, whether you can give us guidance—or certainly give me guidance—over the procedure for statements if information is received later than noon. I ask that question because it now appears that the Cabinet Secretary has protested in the strongest possible way over the manner in which his name and the names of Treasury civil servants have been used purely and simply for party political propaganda. In such circumstances, could a statement be made today?
The distinction between the Government, as such, and party political propaganda is very important. Since the Cabinet Secretary, Sir Robin Butler, has made the strongest possible protest to Treasury Ministers, I believe


that it is necessary for the Chancellor or the Chief Secretary to explain to the House what has happened and why the lies that are being told about the Opposition have been put out and associated with the name of the Cabinet Secretary.

Madam Speaker: Of course, it is perfectly in order for any Minister to make a statement late in the day. Ministers on the Treasury Bench have heard what the hon. Gentleman has had to say. I have not been informed that a statement is forthcoming.

Mr. D. N. Campbell-Savours: On precisely the same matter, Madam Speaker, it is clear that the Cabinet Secretary is extremely angry—

Madam Speaker: Order. I have answered the point of order that was put to me. There were two questions: is it possible for a statement to be made later today, and will one be made? It is possible, but I have not been informed by a Minister that a statement is forthcoming. Those on the Treasury Bench have heard the feelings of the two hon. Members who have raised points of order on that issue.

Mr. Dafydd Wigley: On a point of order, Madam Speaker. I apologise for not having given you notice of this point of order, but I have only just had a fax through about it. You will be aware of the severe weather affecting some parts of these islands. Several villages in my constituency have lost their electricity since yesterday morning, including 200 people in the village of Deiniolen, where several elderly people may be severely affected.
The question has arisen whether Ministers at the Department of Trade and Industry have responsibility for such matters. Can you confirm that it would be in order for the President of the Board of Trade or one of his Ministers to come to the House, in view of the fact that it is a privatised electricity company that is now unable to maintain electricity supplies?

Madam Speaker: It is up to a Minister to determine whether he wishes to come and make such a statement. Of course I am aware of the severe weather in many parts of this country, not only in Wales but in Scotland. No doubt that is the subject of the next point of order to come my way.

Mr. Alex Salmond: Not exactly, Madam Speaker. It is a different point of order. As you know, we are all grateful for the judicious and fair way in which you allocate supplementary questions, but sometimes events can occur that are outwith your immediate discretion. At Scottish questions today, seven of the first 12 questions taken were from hon. Members from English constituencies. That pattern has been repeated over a number of Scottish Question Times.
May I ask you to consider three facts? First, many of those hon. Members left immediately after asking their questions, showing that their interest in Scottish affairs was perhaps not too profound. Secondly, there has been a suggestion that their interest is not entirely spontaneous,

but that they are being orchestrated by the Government Whips' office. Thirdly, the way in which many expressions were made about Scotland causes offence north of the border and moved the normally mild-mannered hon. Member for Dumbarton (Mr. McFall) to something of an outburst. May I ask you to consider whether the procedures of the House are being abused? Is there any intervention that you can make to prevent Scottish questions from degenerating further?

Madam Speaker: I understand the hon. Gentleman's anxiety, but I recall calling two hon. Members from his party during Scottish questions today. It is good to get these things on the record. Out of the total of 46 supplementary questions, 34 were from Scottish Members. I keep a running total as we go through Scottish questions. I should also like to put on record the fact that the Members of the official Opposition tabled 27 questions. It would have been possible for them to table 40, but only 27 were tabled. I like to keep the House informed of the record that I keep up to date.

Mr. Andrew Mackinlay: On a point of order, Madam Speaker. My point arises from your ruling on the Government Whips having listened to the representations in the House about the need for a statement on Sir Robin Butler's refutation of the suggestion that he was involved in assisting the Government politically.
Surely the problem is that the House is impotent to call to account the arbitrary behaviour of Government spokespersons. What measures are at our disposal in this place to stop the arrogance of a Government who behave in that way towards Sir Robin Butler and other civil servants? Is there nothing in our armoury that will enable us to make them make a statement this afternoon?

Madam Speaker: The hon. Gentleman is very wise in the use of our Standing Orders and all our procedures. He needs no guidance from me. There is an Order Paper. He can use Question Time, early-day motions, ten-minute Bills or Adjournment debates. There are so many ways in which he might raise such matters.

Mr. Campbell-Savours: rose—

Madam Speaker: Order. I am hearing no further points of order about that. There is important business before the House.

Mr. Campbell-Savours: It is an important matter.

Madam Speaker: Another matter?

Mr. Campbell-Savours: Could you advise civil servants outside Parliament on a matter of procedure in the Commons—

Madam Speaker: Order. I have no authority over civil servants; my authority is only in the House. That is the answer.

Mr. Campbell-Savours: rose—

Madam Speaker: Order. I ask the hon. Gentleman to resume his seat. I have authority only in this House—nothing to do with civil servants.

BILLS PRESENTED

FLOOD PREVENTION AND LAND DRAINAGE (SCOTLAND)

Mr. Secretary Forsyth, supported by Mr. George Kynoch and Mr. Secretary Hague, presented a Bill to amend the Flood Prevention (Scotland) Act 1961 in relation to flood prevention measures to be taken by local authorities; to repeal section 11(2) of the Land Drainage (Scotland) Act 1930 and section 8(2) of the Land Drainage (Scotland) Act 1941; and for connected purposes: And the same was read the First time; and ordered to be read a Second time tomorrow and to be printed [Bill 36].

KNIVES

Mr. Jimmy Wray, supported by Mr. Don Dixon, Mrs. Audrey Wise, Mrs. Diana Maddock, Mr. David Mellor, Mr. Elfyn Llwyd, Mr. Don Touhig, Mrs. Irene Adams, Mr. Bill Etherington, Mr. Jimmy Hood, Mr. John McAllion and Mr. Jim Cunningham, presented a Bill to create new criminal offences in relation to the possession or marketing of, and publications relating to, knives; to confer powers on the police to stop and search people or vehicles for knives and other offensive weapons and to seize items found; and for connected purposes: And the same was read the First time; and ordered to be read a Second time upon Friday 13 December and to be printed [Bill 16].

PUBLIC ENTERTAINMENTS LICENCES (DRUG MISUSE)

Mr. Barry Legg, supported by Mr. John Whittingdale, Mr. Jacques Arnold, Mr. Nigel Evans, Dr. Ian Twinn, Mr. David Evans, Mr. Bill Walker, Mr. David Shaw, Mr. David Faber, Mr. David Martin, Mr. Walter Sweeney and Mr. Andrew Hargreaves, presented a Bill to amend the law about public entertainments licences relating to places at or near which controlled drugs are supplied or used and for connected purposes: And the same was read the First time; and ordered to be read a Second time upon Friday 17 January 1997 and to be printed [Bill 17].

CONFISCATION OF ALCOHOL (YOUNG PERSONS)

Mr. Nigel Evans, on behalf of Dr. Robert Spink, supported by Mr. Kenneth Baker, Mr. John Patten, Sir Ivan Lawrence, Dame Jill Knight, Mr. David Amess, Mr. David Faber, Sir Michael Shersby, Mr. John Hutton, Mr. Walter Sweeney, Mr. Alan Beith and Ms Janet Anderson, presented a Bill to permit the confiscation of intoxicating liquor held by or for use by young persons in public and certain other places and for connected purposes: And the same was read the First time; and ordered to be read a Second time upon Friday 24 January 1997 and to be printed [Bill 18].

JURISDICTION (CONSPIRACY AND INCITEMENT)

Mr. Nigel Waterson, supported by Sir Ivan Lawrence, Mr. Charles Wardle, Mr. Bob Dunn, Mr. Harry Greenway, Mr. John Marshall, Mr. Michael Brown, Mr. Peter Butler, Mr. John Sykes, Mr. Geoffrey Clifton-Brown, Mr. Nick Hawkins and Mr. Nirj Joseph Deva, presented a Bill to make provision about conspiracy, or incitement, to commit offences outside the United Kingdom: And the same was read the First time; and ordered to be read a Second time upon Friday 31 January 1997 and to be printed [Bill 19].

COLD WEATHER PAYMENTS (WIND CHILL FACTOR)

Mrs. Audrey Wise, supported by Mr. Hugh Bayley, Sir Andrew Bowden, Mrs. Ann Clwyd, Mr. Jeremy Corbyn, Mrs. Margaret Ewing, Ms Liz Lynne, Mrs. Alice Mahon, Mr. Alan Simpson, Mr. Nicholas Winterton, Mr. Jimmy Wray and Mr. Dafydd Wigley, presented a Bill to provide that wind chill factor is taken into account in the calculation of cold weather payments: And the same was read the First time; and ordered to be read a Second time upon Friday 17 January 1997 and to be printed [Bill 20].

PRISONS (ALCOHOL TESTING)

Mr. Bernard Jenkin, on behalf of Mr. John Ward, supported by Mr. Harold Elletson, Mr. Nigel Evans, Mr. David Nicholson, Mr. Nirj Joseph Deva, Sir Irvine Patnick, Mr. Neil Hamilton, Mr. Matthew Banks, Mr. Charles Hendry, Mr. David Congdon and Mr. Michael Brown, presented a Bill to enable prisoners in England and Wales, and other persons to whom provisions of the Prisons Act 1952 are applied by section 43 of that Act, to be tested for alcohol: And the same was read the First time; and ordered to be read a Second time upon Friday 13 December and to be printed [Bill 21].

ROAD TRAFFIC (REDUCTION)

Mr. Don Foster, supported by Ms Joan Walley, Mr. Cynog Dafis, Mr. Peter Bottomley, Mr. Matthew Taylor, Mr. Harry Greenway, Mr. Jim Cousins, Mr. Alan Simpson, Mrs. Anne Campbell, Sir Richard Body, Ms Roseanna Cunningham and Mr. John Marshall, presented a Bill to establish targets for a reduction in road traffic levels in the United Kingdom; to require local authorities to draw up local road traffic reduction plans; to require the Secretary of State to draw up a national road traffic reduction plan to ensure that the targets are met; and for related purposes: And the same was read the First time; and ordered to be read a Second time upon Friday 24 January 1997 and to be printed [Bill 22].

CRIMINAL EVIDENCE (AMENDMENT)

Mr. Nigel Evans, supported by Mr. Joe Ashton, Mr. Ian Bruce, Ms Ann Coffey, Mrs. Ann Clwyd, Mr. Paul Flynn, Mr. David Hanson, Ms Liz Lynne, Mr. Cohn Pickthall, Dr. Robert Spink, Mr. John Sykes and Mr. Nigel Waterson, presented a Bill to make provision extending the categories of persons from whom non-intimate body samples may be taken without consent under Part V of the Police and Criminal Evidence Act 1984; and to add a further time limit to those operating for the purposes of section 63A(4)(a) of that Act: And the same was read the First time; and ordered to be read a Second time upon Friday 24 January 1997 and to be printed [Bill 23].

TELECOMMUNICATIONS (FRAUD)

Mr. Ian Bruce, supported by Sir Michael Marshall, Sir Gerard Vaughan, Mr. John McWilliam, Mr. Nigel Jones, Mr. Andrew Miller, Mr. Robert Maclennan, Mr. William Ross, Mr. Gary Waller, Mr. Roger Gale, Mr Stephen Timms and Mrs. Anne Campbell, presented a Bill to amend the Telecommunications Act 1984 to make further provision for the prevention of fraud in connection with use of a telecommunication system: And the same was read the First time; and ordered to be read a Second time upon Friday 13 December and to be printed [Bill 24].

UNITED NATIONS PERSONNEL

Mr. John Marshall, supported by Mr. Norman Hogg, Mr. Harry Greenway, Mr. Michael Alison, Mr. David Sumberg, Mr. David Harris, Mr. Greville Janner, Mr. Jacques Arnold, Rev. Martin Smyth, Mr. Simon Coombs, Mr. Michael Stern and Mr. Michael Brown, presented a Bill to enable effect to be given to certain provisions of the Convention on the safety of United Nations and associated personnel adopted by the General Assembly of the United Nations on 9th December 1994: And the same was read the First time; and ordered to be read a Second time upon Friday 17 January 1997 and to be printed [Bill 25].

GENERAL TEACHING COUNCIL (ENGLAND AND WALES)

Sir Peter Fry, on behalf of Sir Malcolm Thornton, supported by Mr. Don Foster, Sir Alan Haselhurst, Mr. David Jamieson, Mr. Alan Meale, Mr. David Porter and Mr. Gerry Steinberg, presented a Bill to provide for the establishment in England and Wales of a General Teaching Council, with the functions of developing, promoting and regulating the practice of the profession of teaching, and for connected purposes: And the same was read the First time; and ordered to be read a Second time upon Friday 24 January 1997 and to be printed [Bill 26].

LOCAL GOVERNMENT (GAELIC NAMES) (SCOTLAND)

Mr. Thomas Graham, supported by Mr. Jim Cunningham, Mr. Don Dixon, Mr. Jimmy Wray, Mr. Brian Wilson, Mr. Calum Macdonald, Mrs. Maria Fyfe, Mr. Gordon McMaster, Mr. John McAllion, Mr. Jimmy Hood and Mr. Eric Clarke, presented a Bill to enable local authorities in Scotland to take Gaelic names; and for connected purposes: And the same was read the First time; and ordered to be read a Second time upon Friday 13 December and to be printed [Bill 27].

HUMAN FERTILISATION AND EMBRYOLOGY (CONSENTS)

Mrs. Anne Campbell, supported by Mr. Joe Ashton, Mrs. Helen Jackson, Mr. Malcolm Chisholm, Mrs. Maria Fyfe, Mrs. Teresa Gorman, Mrs. Audrey Wise, Sir Gerard Vaughan and Sir David Steel, presented a Bill to amend Schedule 3 to the Human Fertilisation and Embryology Act 1990 so as to provide that consents to the use of gametes or embryos may exceptionally be given other than in writing: And the same was read the First time; and ordered to be read a Second time upon Friday 13 December and to be printed [Bill 28].

WITNESS PROTECTION

Mr. Eric Clarke, on behalf of Mrs. Irene Adams, supported by Mr. Gordon McMaster, Mr. William McKelvey, Mr. Ken Maginnis, Mr. Joe Ashton, Mr. Phil Gallie, Ms Roseanna Cunningham, Mr. Roger Stott, Mr. Jimmy Hood, Mr. Robert Litherland and Mr. John McFall, presented a Bill to provide further protection for victims and other witnesses in criminal trials: And the same was read the First time; and ordered to be read a Second time upon Friday 31 January 1997 and to be printed [Bill 29].

POLICE (HEALTH AND SAFETY)

Mr. Ray Whitney, supported by Mr. Alan Beith, Mr. John Greenway, Dame Jill Knight, Sir Peter Lloyd, Mr. Elfyn Llwyd, Mr. Andrew Mackinlay, Mr. Ken Maginnis, Mr. Andrew Miller, Mr. Ian Pearson and

Mr. Walter Sweeney, presented a Bill to make provision about the health, safety and welfare at work of members of police forces, special constables, other persons having the powers or privileges of a constable, and police cadets; and for connected purposes: And the same was read the First time; and ordered to be read a Second time upon Friday 31 January 1997 and to be printed [Bill 30].

SEXUAL OFFENCES (PROTECTED MATERIAL)

Mr. Robert G. Hughes, supported by Mr. Simon Coombs, Mr. David Congdon, Mr. Jim Cunningham, Mr. Simon Hughes, Mr. John Marshall and Mr. Don Touhig, presented a Bill to make provision for regulating access by defendants and others to certain categories of material disclosed by the prosecution in connection with proceedings relating to certain sexual and other offences: And the same was read the First time; and ordered to be read a Second time upon Friday 31 January 1997 and to be printed [Bill 31].

BREEDING AND SALE OF DOGS

Mrs. Diana Maddock, supported by Mr. Roger Gale, Mrs. Jane Kennedy, Mr. Matthew Taylor, Mr. David Amess, Mrs. Bridget Prentice, Mr. Cynog Dafis, Sir Andrew Bowden, Mr. Tony Banks, Mr. Simon Hughes, Mr. Harry Greenway and Mr. David Jamieson, presented a Bill to amend and extend certain enactments regulating the breeding and sale of dogs; to regulate the welfare of dogs kept in breeding establishments; to extend powers of inspection and for purposes connected with those matters: And the same was read the First time; and ordered to be read a Second time upon Friday 17 January 1997 and to be printed [Bill 32].

POLICYHOLDERS PROTECTION

Mr. John Butterfill, supported by Mr. Malcolm Bruce, Mr. John Greenway, Ms Joan Walley, Mr. Douglas French, Mr. Nick Hawkins and Mr. David Trimble, presented a Bill to amend the Policyholders Protection Act 1975; and for connected purposes: And the same was read the First time; and ordered to be read a Second time upon Friday 24 January 1997 and to be printed [Bill 33].

POLICE (PROPERTY)

Mr. David Evennett, supported by Mrs. Elizabeth Peacock, Mr. Matthew Carrington, Mr. Jacques Arnold, Mr. David Porter, Mr. David Congdon, Mr. David Jamieson, Mr. Andrew Mackinlay, Mr. Patrick Thompson, Mr. Jim Callaghan and Mr. Simon Hughes, presented a Bill to make further provision with respect to property in the possession of the police: And the same was read the First time; and ordered to be read a Second time upon Friday 17 January 1997 and to be printed [Bill 34].

PHARMACISTS (FITNESS TO PRACTISE)

Sir Michael Shersby, supported by Sir John Hannam, Mrs. Margaret Ewing, Rev. Martin Smyth, Mr. Harry Greenway, Mr. Anthony Steen, Sir Gerard Vaughan, Mrs. Llin Golding, Ms Angela Eagle, Mr. John Wilkinson, Mr. Richard Alexander and Mr. Gordon Oakes, presented a Bill to make provision about finding registered pharmaceutical chemists unfit to practise due to ill health; and for connected purposes: And the same was read the First time; and ordered to be read a Second time upon Friday 17 January 1997 and to be printed [Bill 35].

Opposition Day

[2ND ALLOTTED DAY]

National Health Service

Madam Speaker: I have selected the amendment standing in the name of the Prime Minister.

Mr. Chris Smith: I beg to move,
That this House reasserts its belief in the fundamental principles of the National Health Service, established fifty years ago, that health care should be available to all, based on need and not on ability to pay; expresses its dismay at the changes effected by Her Majesty's Government, which are undermining these principles; is alarmed at the way in which the competitive internal market in the NHS is distorting decisions on patient care, creating a two-tier inequitable service, and has led to an explosion of unnecessary and expensive bureaucracy; expresses grave concern about the impending winter crisis in the NHS in many parts of the country, about which Her Majesty's Government appears wholly unconcerned; resolves to take wasteful expenditure out of the bureaucratic procedures of the internal market and devote it instead to improving patient care; and seeks to restore the ethos of the NHS to that of a public service, not of a commercial competitive business.
The starting point for this debate must be a reassertion of our fundamental belief in the founding principles of the national health service, which was founded 50 years ago with the clear statement that health care should be available according to need, not according to ability to pay. The crucial question is whether those principles are being carried out in practice in the here and now. It is the Opposition's contention that the Government's actions, especially in the past five or six years, have fundamentally undermined those founding principles.
Of course the Government say that they believe in the national health service and its principles; they issued a White Paper a few days ago to make that point at great length. However, we must turn our attention to what is happening in the health service throughout the country now, not in a fictitious future conjured up in a White Paper full of warm words and lacking a single legislative proposal. There is a large gap between the Government's rhetoric and what is happening on the ground.

Mr. Jerry Hayes: On the subject of rhetoric, has the hon. Gentleman seen the splendid article in The Independent, entitled "Is the NHS safe under Dr. Blair's team?" Does the hon. Gentleman prefer the point that says:
Labour's complacent attitude, which has focused on scoring points in opposition rather than constructing a viable alternative",
or the point from the left-leaning Institute for Public Policy Research, which says:
From where we stand now, there will be no significant new public money for health care in the UK."?
Which of those is right?

Mr. Smith: I had expected rather better from the hon. Gentleman, who is normally more intelligent. If he had read the article that I wrote in response to that piece three days after it was published, he would know that neither of those accusations contained any truth whatever.
The reality is that the national health service is facing a crisis this winter, and everyone in the NHS knows it. The chairman of the consultants committee of the British Medical Association has said that the service is "close to collapse" and the National Association of Health Authorities and Trusts has said that there are serious problems and that the health service faces the worst situation for years; only the Government seem to be unperturbed about what is happening on the ground.

Mr. David Winnick: Did my hon. Friend see the article in last night's Evening Standard by its art critic? I strongly doubt whether he is a long-standing Labour supporter, but he wrote about his heart attacks and about the fact that he had to choose private surgery because of the crisis in the national health service. Does not that illustrate yet again how many people in our country feel betrayed by the Government because the national health service is not in a position to help when help is absolutely essential?

Mr. Smith: My hon. Friend makes a valid point. I never want the day to come when people feel that they have to go private because the national health service cannot deliver the care that they expect and to which they are entitled.

Mr. Hugh Bayley: Does not that answer illustrate the fact that under Conservative management the number of private beds in the national health service has increased year on year to the point where people are encouraged to go private?

Mr. Smith: My hon. Friend is right. The private content of health provision has more than doubled under the Conservatives; the figure for private treatment is 11 per cent. and rising. I believe from what he has told the press that the Secretary of State for Health has private medical insurance.
In figures presented to the House in an answer to my hon. Friend the Member for Newham, South (Mr. Spearing) a few weeks ago the Government had to admit that health authorities throughout the country will face an overall net deficit of about £120 million by the end of this financial year. What the Government cannot tell us, or at least they say that they cannot tell us, is how much deficit trusts are facing. However, the Health Select Committee has helpfully assisted us by showing that serious deficits are looming for a range of hospital trusts.

The Secretary of State for Health (Mr. Stephen Dorrell): I would not like the hon. Gentleman to develop his argument on the basis of a misunderstanding of the position. Some questions have been tabled about the financial position of trusts. We are preparing answers and intend to publish them. The net figure anticipated for the end of this financial year for the whole trust sector is a surplus of £60 million.

Mr. Smith: That is indeed interesting and new information. If this debate does nothing else, it has been useful in flushing that out. If that is the case, can the Secretary of State explain why the Royal Sussex county hospital has cancelled all dialysis for new patients for the rest of the financial year; why the King's Healthcare NHS trust has increased its waiting times for orthopaedic


patients to 18 months, even for patients with infected hips; why Merton, Sutton and Wandsworth health authority has decided not to contract for any elective surgery from St. Helier NHS trust and St. George's NHS trust next year; or why no new ear, nose and throat patients are being taken on by the Royal Hospitals NHS trust in London for the remainder of the financial year? If there is such a healthy surplus in our hospitals, why are they withdrawing care and treatment from patients with every week and month that passes?

Mr. Brian David Jenkins: My local trust took two and a half years to find that it was £1.5 million in debt. The financial regulations and the state of accountability are such that I do not know any trust that can say that it will be in surplus or debt next year because of the way in which they are run. Many of them simply do not know.

Mr. Smith: My hon. Friend is right. Does the £60 million that the Secretary of State told us about take account of the £100 million that the recent decision of Customs and Excise on the repayment of VAT to hospital trusts will cost hospital trusts in the course of the year?

Mr. Dorrell: The hon. Gentleman may have missed the fact that Customs and Excise announced at the end of October that it was giving every trust, health authority and NHS body until the end of November to submit applications for VAT repayments. The story that has been running in the newspapers on that subject is wrong, too.

Mr. Smith: The Secretary of State ignores the fact that that does not apply to money that was paid out in VAT two or three years ago and which has not yet been reclaimed. The fact is that health trusts say that the recent decision by Customs and Excise eases the burden but does not remove it entirely. Whereas previously the burden might have been some £160 million, health trusts estimate that it will be about £100 million after the Government's recent announcement. Clearly, the Secretary of State does not know what is happening.

Mr. Dorrell: I am not sure about that. Will the hon. Gentleman explain how an organisation can assess outstanding VAT so that it can provide the estimate that the hon. Gentleman gave but cannot send it to Customs and Excise to reclaim the tax?

Mr. Smith: That is what the hospital trusts are saying and I place greater credence on what they say than on what the Secretary of State says.

Mr. Nigel Spearing: A few moments ago my hon. Friend asked why the Royal Hospitals NHS trust had to make cuts. Is he aware that yesterday the East London and The City health authority announced cuts in the forthcoming year of £14 million of general treatment—an additional £4 million is to be announced in January, which could mean the closure of St Andrew's hospital, Bow—despite the fact that its capitation from the Secretary of State is about 600,000, yet the doctors' lists are 700,000? If that anomaly were corrected, would not some of those difficulties be removed?

Mr. Smith: My hon. Friend has identified two factors. The first is that the Government often get their figures

wrong—they have clearly done so in my hon. Friend's case as they do in many others. Secondly, there is an enormous gulf between the reality of what happens—in hospitals, health authorities and health services received by people up and down the country—and what the Government say is happening. There is a serious difference between what the Government say and what is being experienced.
What is the Secretary of State doing about the winter crisis that is affecting east London and hospitals elsewhere in the country? Everyone in the health service knows that there is a serious problem looming. What is the Secretary of State doing about it? Precisely nothing. When he was pressed specifically on that point on television on Sunday he said clearly and firmly that there was no new money available this year to help hospitals through the crisis. He then said, "But it is the expectation of what will happen next year that really matters and makes the difference in the decisions that hospitals and health authorities have to make." What is he saying? Is he saying to health trusts that cannot legally overspend, "Don't worry; overspend if you have to. Get through the winter. Don't alarm the electorate in advance of a general election—help will be coming along in next year's funds"?
I offer the Secretary of State the opportunity of today's debate to spell out precisely what he is saying to health trusts and health authorities around the country. Is there to be money this year or is there only going to be extra money next year—placating this year's crisis with next year's funds? If so, what happens next year? If he uses up next year's money to try to resolve this year's crisis, we shall end up with exactly the same problem next year. Instead of year on year on year of additional funding for the health service—the mantra that the Secretary of State likes to chant—it will be year on year of winter crises in the health service under a Tory Government.

Lady Olga Maitland: Perhaps the hon. Gentleman will enlighten the House. Instead of criticising the Government on their handling of health policies, which is satisfactory, perhaps the hon. Gentleman will tell the House what his party would do. Would it spend more money on health? If so, would that money be in addition to the pledges already given which would increase taxation by 9p in the pound? We should be told.

Mr. Smith: I am surprised that the hon. Lady does not seem to be worried about what is happening at St. Helier hospital, which I should have thought would have been of concern to her constituents. I am astonished at the hon. Lady who, along with the Secretary of State, says that the Labour party will not spend more money on the health service. Meanwhile, the Chief Secretary to the Treasury and the chairman of the Conservative party publish documents purporting that Labour will spend an extra £1.3 billion on the health service. Can they make up their minds? Do they believe that we will spend more money on the health service, or that we will not? There are two voices coming from the Tory party—sometimes two voices coming from the same person. I am sure that we are about to hear them from the Secretary of State.

Mr. Dorrell: I have been too kind to the hon. Gentleman, because I have always assumed that the


proposals that were set out this morning by my right hon. Friend the Chief Secretary and which would have the effect of increasing costs in the health service without treating a single extra patient would be paid for out of a Labour extra spend. Is the hon. Gentleman saying that those extra costs would be paid for by the fewer patients who would be treated in Labour's health service?

Mr. Smith: The Secretary of State is talking as much rubbish as the Chief Secretary did. He must concern himself with what is happening now in the health service.
The right hon. Gentleman must also show particular concern for the position in Northern Ireland. The Under-Secretary of State for Northern Ireland has publicly acknowledged that the 3 per cent. efficiency savings that the Government have required of the health service in Northern Ireland cannot be made through efficiency alone. The Labour party did not say that and nor did anyone in the health service—it was the Government's own Minister who said that the effect of the 3 per cent. cut in funding for Northern Ireland, supposedly for efficiency purposes, actually involves 1.5 per cent. of cuts in the service. I am surprised that the Secretary of State shows such a cavalier attitude to a Minister in his own Government admitting that the requirements of funding in the current financial year in Northern Ireland mean a cut in service of 1.5 per cent.

Mr. Simon Hughes: The hon. Gentleman will know that I endorse his criticism of both the deficit in funding for this winter and the risk of deficit in the years to come and that I share his commitment to the NHS. However, he owes the House an obligation to confirm whether it is currently Labour policy that the only additional funding committed to the NHS by the Labour party is £100 million to be derived from bureaucracy savings; and that, as the shadow Chancellor confirmed this morning, there will be no more money from the Labour party for the NHS in the foreseeable future.

Mr. Smith: I am surprised that the hon. Gentleman has fallen into precisely the trap that the Tories want him to fall into. Before we can go with any real confidence to the Chancellor, the shadow Chancellor or the taxpayers of this country to argue for additional funds for the national health service, we have to be able to demonstrate that every single penny that is currently raised and spent is being spent wisely. I have to tell the hon. Gentleman that that is not the case at the moment—it is self-evidently not the case from the bureaucratic procedures that have been introduced with the internal market.
Indeed, it is precisely that competitive internal market that is worsening the current winter crisis. It is setting hospital against hospital and doctor against doctor; it is leading to the fragmentation of the service and a lack of strategic planning; and it is distorting decisions on patient care.

Mr. Cynog Dafis: Will the hon. Gentleman give way?

Mr. Smith: I have given way a lot, but I shall give way for the final time to the hon. Gentleman.

Mr. Dafis: The hon. Gentleman speaks of hospitals being set against hospitals. May I draw his attention to

the situation in mid-Wales, where it is clear that the only way in which Ceredigion and Mid-Wales NHS trust will be able to cope financially next year is by either reducing the range of services at the district general hospital, or closing community hospitals? Is not that an intolerable dilemma?
Does the hon. Gentleman agree that community hospitals have an essential place and that trusts should not be put in that sort of position? Will he make it clear that his party, when in government—I ask this question in all sincerity—will ensure that hospitals and trusts of that sort will be protected against the unreasonable rigours of the internal market?

Mr. Smith: The hon. Gentleman is right to draw attention to the problems confronting community hospitals and cottage hospitals throughout the country. The Conservative Government told us at the Tory party conference that they believed that reinventing the cottage hospital was the way forward. They are right to regard that as an essential ingredient of a good-quality health service of the future, but perhaps they can tell us why they have closed 250 cottage hospitals in the past five years. As always, the Government's rhetoric on the Tory party conference platform is not reflected in what is happening in the health service.
The introduction of the internal competitive market has introduced a two-tier service into the NHS. Anyone who doubts that need only consider what is happening in Lincoln County hospital. It has written to all non-fundholding GPs in its area, saying that it is cancelling all out-patient appointments for the rest of the financial year; but out-patient appointments are continuing for the patients of fundholders.
Norfolk and Norwich hospital has cancelled all routine surgery for patients of non-fundholding GPs. Edinburgh Western General hospital has told patients of fundholders that they can be given diagnostic scans in one or two weeks, but patients of non-fundholders must wait a year.
Yesterday, The Times published a letter by the consultant orthopaedic surgeon at St. Thomas' hospital, just the other side of the river from the House. He said:
At St. Thomas' Hospital surgeons have been advised by the local purchasing authority that it will pay only for patients who are medically urgent or who have been on the waiting list 18 months. A fundholding patient can be seen and treated much more quickly.
That is the reality in hospital after hospital throughout the country. The patients of fundholders are able to obtain access to treatment in a very different way from patients of non-fundholders. That situation is a fundamental breach of the principles of equity, fairness and equal access to treatment that are supposed to be at the heart of the national health service.

Mr. Dorrell: The hon. Gentleman has just made an oft-repeated charge against the fundholding scheme. It is a golden opportunity for him to tell the House his policy for the future of fundholding.

Mr. Smith: Before I do so, perhaps the Secretary of State will tell us what he will do about restoring equity to the national health service, because the Government in which he serves and his policies have created the unfairnesses and the injustice. It cannot be right that


patients living in the same street, with the same condition and the same needs, are treated differently because they have a different type of general practitioner.
The Secretary of State says that everyone now accepts the market changes that the Government have introduced. He said frequently on radio and television last week, backing his White Paper, that he was seeking to draw a line under the changes to the health service because everyone agreed with them now, so he wanted to move on to other things.
I must tell the Secretary of State that everyone does not agree with the changes. One of the reasons why we do not agree is that the two-tier nature of the service that has been created fundamentally undermines what the NHS is supposed to be about. As the hon. Member for Southwark and Bermondsey (Mr. Hughes) pointed out, we want among other things to take money out of unnecessary bureaucratic procedures—the invoices for every patient, the paperwork chasing itself from one end of the system to the other, and the fact that a hospital such as Great Ormond Street each year has to establish 60 contracts with health authorities around the country and 1,500 contracts with fundholding practices. There are now 20,000 more managers in the NHS than there were five years ago and 50,000 fewer nurses. That speaks volumes about the Government's priorities for the health service.
The British Medical Association estimates that the internal market bureaucracy which the Government have imposed on the health service costs £1.5 billion a year. Certainly, we want to take money out of red tape and put it into patient care, because that is what is desperately needed.
Ministers will say that everything is fine because of the Prime Minister's commitment to increase funding for the health service year on year. The people of Britain will recall that he is the same Prime Minister who promised tax cuts year on year at the election, yet the Government have ended up putting up taxes 22 times since then.
What does this supposed commitment from the Government actually mean?

Mr. Dorrell: More money.

Mr. Smith: How much more money? How much do the Government actually mean to spend on the health service? What are the figures? The Chancellor of the Exchequer gave a revealing interview just a few minutes after the Prime Minister had made his speech to the Conservative party conference. On Sky News, a reporter pressed the Chancellor on how important the commitment was. "What is the minimum?" he asked. The Chancellor replied:
Oh well, there's … What we actually did was not say"—
whereupon the reporter interrupted as follows:
You can't say. It could be £1 above inflation!
The Chancellor replied:
We've not planned for five years ahead, it could be a lot of, um … everything depends on getting the economy right.
So much for the pledge that the Government have given us—it all depends on getting the economy right. Under pressure from the reporter, the Chancellor had to admit that he could not say what the expenditure would amount to.
It is always useful to read the book instead of gazing into the crystal ball. During the 20 years to 1992, under Governments of both political persuasions, average real-terms growth in expenditure on the health service—even under Lady Thatcher—was 3.1 per cent. And what have the Government managed during the past five years? They have managed an average of 2.9 per cent. The Red Book which accompanied last year's Budget tells us that there will be a 0.6 per cent. increase in real-terms NHS-expenditure next year, and a 0.1 per cent. increase the year after that. If the Government match that, they will have fulfilled the Prime Minister's promise—but by an amount way below the solid average rate of increase achieved by previous Governments.
We are told that the Secretary of State for Health has fought the good fight with the Chancellor and secured extra resources over and above 0.6 per cent. for next year. I expect that the sum will be rather more than the £500 million that has been leaked to the press, probably by his own Department, because he likes to massage public opinion in advance and create the expectation of a particular figure. Lo and behold, when a larger amount is allocated, a great triumph is proclaimed.
Whatever the figure is, I bet you, Madam Deputy Speaker, that it will be below the 3.1 per cent. average that previous Governments achieved. For the record, the last five years of the Labour Government achieved a 16 per cent. increase in real-terms in national health service expenditure. During the past five years this Government have achieved a real-terms increase of 14 per cent., so they have performed worse than the previous Labour Government and we will take no lessons from them about our commitment to the funding of the NHS.
The Prime Minister made no mention of capital spending in the national health service. There is no mention of it in the White Paper. There is no mention of the Government's 17 per cent. cut in capital spending in the health service. They will tell us, of course, that the private finance initiative will close the gap. That is what they told us in the Red Book last year. At the time of the Budget last year, the Red Book stated:
Several large hospital private finance schemes are due to complete the procurement process and receive approval in 1995–96"—
that was a year ago, not the current financial year—
with a total capital value of around £250 million.
The Red Book goes on to state that
by the end of next year it is expected that projects worth £1 billion will have come forward for approval. During 1996–97 it is expected that the private sector will invest around £165 million in NHS facilities and these figures are expected to be exceeded in subsequent years.
Perhaps the Secretary of State can tell us why not a single brick has been laid in a single hospital scheme under the PFI to date.

Sir Norman Fowler: Will the hon. Gentleman give way?

Mr. Smith: Perhaps the Government can also tell us why hospital after hospital around the country and contractor after contractor complain about the


bureaucratic process, the expense, the complexity and the inadequacy of the PFI system for funding hospital building work. I will give way for the final time.

Sir Norman Fowler: Will the hon. Gentleman concede that the biggest cuts in the capital programme for hospital building were made by the last Labour Government in the 1970s? That is indisputable.

Mr. Smith: Perhaps the right hon. Gentleman can tell us why, back in 1990, the Government promised that Norwich would have its new hospital under the private finance initiative, yet it is still not signed, sealed and delivered. The Government relaunch the plan every year and tell us that it is about to happen, but Norwich is still waiting for its new hospital.
There are two more specific points that I want to raise. The first relates to mixed sex wards in hospitals. The Patients Association is right to describe having to be in a mixed sex ward against one's will as an affront to the dignity of the patient. It causes distress and concern to many patients, especially women, to be placed in a mixed ward when they do not want to be in such a ward. This, of course, happens at a time of great trauma: when patients face surgery or treatment.
When my right hon. Friend the Leader of the Opposition pressed the Prime Minister on this point yesterday, he pointed out that that promise was made by the Government two years ago in the patients charter. Yet it remains unfulfilled. In January 1995, the patients charter said that patients could expect single-sex washing and toilet facilities and that their wish to be treated in single-sex wards
will be respected wherever possible".
Those two promises sound very good on paper, but the report from the Patients Association yesterday revealed that segregated washing and toilet facilities are far from being the norm, and that patients throughout the country commonly report that if they express a preference to be treated in a single-sex ward—as the charter encourages them to do—they are suddenly told that their wait for treatment will be far longer as a result. The pledge in the patients charter effectively offers patients only a Hobson's choice, and it is not worth the paper that it is written on.
In addition, I am very concerned that the Department of Health does not even collect information on hospitals that force patients on to mixed sexed wards against their will. The Prime Minister did not appear to understand the question when asked by my right hon. Friend yesterday, let alone answer it.
In almost every case, both men and women prefer to be treated in single-sex wards in hospital. Labour believes that it should be a matter of good practice, and the improved management of beds to achieve this end should be one of the priorities in the Government's management of the health service.

Mr. Dorrell: It is.

Mr. Smith: The Secretary of State says that it is, but the Prime Minister appeared to disagree with that yesterday. He was saying, "There are other things that are more important. We have been concentrating on other things. Then in due course we'll turn to this matter." He does not recognise the urgency of the matter and the need to deal with it in the immediate future.
The second issue that I wish to raise is the gagging of national health service staff, who are told in their contracts that they cannot speak out about the service in general or in particular. It is all right, of course, for the bigwigs who support the Government. The national health service "good news network" has been established by the Conservative party. Four of the group's regional organisers hold positions on trusts and health authority boards. They include Mrs. Audrey Collins, chair of South Tees Acute Hospitals NHS trust, Charles Bunker, director of East Hertfordshire NHS trust, Mrs. Mary Firth, chair of the Royal Oldham Hospital and Community Services NHS trust, and Mrs. Susan Wrigley, chair of the North Yorkshire health authority.
The good news network in the national health service is supposed to supply information to help the Government. It engages in overtly political activities, such as
feeding back good news stories so that Ministers and Conservative Central Office can use them.
There is one rule for them, but for ordinary staff in the national health service it is completely different. [Interruption.] The Secretary of State says that that is total rubbish.

Mr. Dorrell: Yes, I do.

Mr. Smith: Perhaps he would like to say that to the ambulance man from Surrey ambulance service whom I met this morning. He told me that he had written a letter to his local newspaper to complain about the downgrading of the local fire station and the implications that it would have for other emergency services in being able to reach and treat patients. He is now threatened with disciplinary action by the Surrey ambulance service. If the Secretary of State means what he says—that it is perfectly all right for people who work in the health service to speak out about what they see and are worried about and to raise complaints of a general nature about what is happening in the service and in their area—perhaps he will tell not just the Surrey ambulance service but hospital after hospital throughout the country, as they are disciplining members of staff who speak out. Perhaps he will tell them that the Government's policy has changed, because it certainly has not changed on the ground.
We have a health service that is in crisis, that tries to silence its members of staff, that cannot even deliver same sex wards to the people who wish to have them. Year on year, the Government creates a winter crisis. Year on year we see an explosion of bureaucracy. Year on year we see more managers and fewer nurses. Year on year, we see patients on trolleys in accident and emergency departments. Year on year we see cancelled operations. Year on year we see lengthening waiting lists. Year on year we see staff in the health service struggling to cope with the changes that the Government have imposed on them.
The Labour party believes that the national health service should be run as a public service, not a commercial business. Health care is not something that can be bought and sold in the marketplace. It is too important for that. The NHS should not be for contracts, invoices or market forces; it should be for patients, first, second and third. It will take a Labour Government to rescue and restore a real health service in this country.

The Secretary of State for Health (Mr. Stephen Dorrell): I beg to move, To leave out from "House" to the end of the Question and to add instead thereof:
believes the National Health Service is one of the success stories of modern Britain and is wholeheartedly committed to developing the NHS on the basis of its founding principles of universality, high quality and availability on the basis of clinical need, without regard for the patient's ability to pay; expresses its support for the Government's initiatives to release £300 million from unnecessary NHS administration; welcomes both the Government's further plans to develop NHS primary care and the recent White Paper A Service With Ambitions, which sets out a medium-term framework for a high-quality patient-focused NHS; and welcomes the Government's pledge to spend more money on the NHS, over and above inflation, for each year of the five years of the next Parliament.
The House has just heard a speech of breathtaking complacency from the hon. Member for Islington, South and Finsbury (Mr. Smith). Not only that, his speech further demonstrates, if it were necessary, the bankruptcy of the Labour party—the dilettante approach that it has taken for 17 years to the development of health policy.
We are having this debate because the Opposition Front Bench chose health as the subject for today's debate—

Mr. Chris Smith: Yes, and we will keep on doing so.

Mr. Dorrell: I look forward to it—every week if we can have this kind of debate and speech from the hon. Gentleman.
We might have expected, as the Opposition chose this subject for debate, that they would have had something to say. Instead, we have heard a tissue of innuendo and half truth, undermining public confidence in a great public service. Frankly, there is something rather indecent about the spectacle of the hon. Gentleman luxuriating in anecdotes of service weakness while offering absolutely nothing of any substance as to what he thinks should be done to strengthen, build and plan for the future of the national health service.
We heard not even the merest hint of a policy from the hon. Gentleman this afternoon, simply the complacent suggestion that the national calamity of a Labour Government somehow offers a short cut into a garden of Eden for the national health service. Let us take his arguments one by one and analyse what he told the House.

Mr. Spearing: Will the Secretary of State give way?

Mr. Dorrell: No, I shall develop my argument and give way later.
Let us begin by examining the so-called arguments—that is a grand word to describe what the hon. Gentleman used. He referred to the statistics that were much beloved of his predecessor, the hon. Member for Peckham (Ms Harman), but mere repetition does not make them true. They like talking about 50,000 fewer nurses. The only problem with that argument is that the nursing work force of the national health service has grown by 55,000 under the Conservative Government, and the nursing work force today is at exactly the same level as it was in 1990. It is simply not true to say that the nursing work force in the health service has decreased.
The hon. Gentleman and his hon. Friends like to talk about the increasing number of managers in the NHS, but they speak with forked tongue on that subject. In June this year, the Leader of the Opposition told the Daily Mirror:

The Health Service needs to be managed and the management probably needed to be improved.
When they are under pressure, Labour Front Benchers acknowledge that the traditional system of management in the health service was inadequate. The Leader of the Opposition and the hon. Gentleman's predecessor, the hon. Member for Peckham, have said so repeatedly. A few years ago, the Socialist Health Association said that the NHS was "traditionally under-managed" and that Labour "should avoid bureaucrat-bashing". That is rather good advice, and the hon. Gentleman would do well to take it.
The hon. Gentleman should also examine the Labour party's record when it comes to squeezing unnecessary administrative costs from the health service. We would take his comments about squeezing out £100 million in unnecessary administrative costs more seriously if it were not for the fact that every Opposition Member voted against abolishing regional health authorities, which removed £100 million in unnecessary administrative costs from the health service at a stroke. We introduced a programme to make administrate savings of £300 million in the two years ending next March. It would be nice if Opposition Front Benchers recognised our achievements occasionally rather than glibly asserting that they would knock off £100 million—without providing any evidence of how they would do it.
In his closing passage, the hon. Gentleman mentioned waiting lists. I think that he used the phrase, "year-on-year increases." That is an impossible charge that does not reflect what has happened to waiting lists in the past five years since we began to take effective action to reduce waiting times in the national health service. In 1979, one in four patients waited for more than a year for elective surgery. That figure is now one in 250—a huge cut.

Mr. Smith: Will the Secretary of State tell us the total waiting list figure for the last quarter, which was published only a month and a half ago? Did that figure show an increase or a decrease?

Mr. Dorrell: The hon. Gentleman should consider what is important—I believe that it is the time that individuals spend on the waiting list. In 1979, one in four patients waited more than a year for treatment. That figure is now one in 250. Does the hon. Gentleman deny that that is an improvement in the waiting time performance of the health service? Will he go to the Dispatch Box and say that things have not improved when the number of people waiting more than a year for treatment has fallen from one in four to one in 250?

Mr. Smith: In other words, the Secretary of State's answer to my question is that the waiting list figure has increased.

Mr. Dorrell: I simply ask the hon. Gentleman whether he believes that we should focus on improving the performance of and the service provided by the NHS, or play silly statistical games.

Mr. John Garrett: What does the Secretary of State mean by "waiting list"? The greatest increase has been in the number of people awaiting a first out-patient appointment. In my constituency and in


London, people often wait six or eight months for their first out-patient consultation before they go on the waiting list for an operation in a year or 18 months.

Mr. Dorrell: I mean exactly what the last Labour Government meant by the term "waiting list": the number of people who have been told by their consultants that they need a particular course of treatment and are waiting to receive it—the published figure. There has been a huge improvement in the quality of service delivered by the NHS, and it is simply dishonest to talk about a deterioration in the NHS waiting list performance.
So much for the hon. Gentleman's arguments. Let us look at what a Labour Government would do. Although the hon. Gentleman offered no hints this afternoon, I would like to discuss some evidence with the House.

Sir Donald Thompson: I know that my right hon. Friend has many important points to make and I thank him for giving way. I fear that, as usual, he is being too generous. He has not put his finger on the reason why the hon. Member for Islington, South and Finsbury (Mr. Smith) is sitting on the Opposition Benches and why we have been sitting on the Government Benches for nearly 20 years. When Labour controlled the health service, it was not Health Ministers but convenors of the local union who determined who would have operations in area after area, month after month. It is not a myth; it is the truth. Furthermore, patients who died while on waiting lists in Liverpool could not be buried until the same convenor said it was their turn. That is why the Conservatives are on the Government Benches and why we shall stay here.

Mr. Dorrell: As ever, my hon. Friend advances exactly the right argument. There has been a huge improvement in the quality and range of NHS services and in the conditions outside it—to which my hon. Friend referred—which disrupted patient services in a quite indefensible manner in the declining years of the last Labour Government.
Let us consider what Labour would do. That consideration did not detain the hon. Gentleman while he was at the Dispatch Box this afternoon, but I suppose that that is not surprising: he does not believe that he must answer the academic question what he might do if he were responsible for the health service. Let us begin with money. The Prime Minister has made crystal clear the Conservative Government's commitment to real-terms growth, year by year, in spending on the national health service during the next Parliament. I agree with the comments of the hon. Member for York (Mr. Bayley) to the Fabian Society earlier this year. He said:***
Labour's health policy will not look credible at the general election if we do not commit ourselves to matching the rate of growth delivered by the Conservatives in recent years.
He is spot on, and he should persuade the hon. Member for Islington, South and Finsbury and the shadow Chancellor, the right hon. Member for Dunfermline, East (Mr. Brown), of the force of his argument, or he will take the rap in York.

Mr. Bayley: It is hardly a great promise by the Government to increase health spending in real terms—after all, every Government have done that in every year since the national health service was

established to meet increasing demand arising from an aging population and new treatments. The Secretary of State presented to the Health Committee this year figures that show that, during the past five years, real-terms growth in spending on the NHS has decreased from 6.5 per cent. to 5.4 per cent., 3.3 per cent., 1.9 per cent. and 0.7 per cent. Growth has decreased year after year, to a point where it can no longer pay for the increased costs of aging and new technologies and treatments.

Madam Deputy Speaker (Dame Janet Fookes): Order. The hon. Member for York is beginning to make a short speech. He must wait his turn.

Mr. Dorrell: The hon. Gentleman's speech is extremely helpful to the Government, because he reveals why the hon. Member for Islington, South and Finsbury and his shadow Cabinet colleagues dare not give the same pledge as the Prime Minister. To do so, they would have to reveal the skeleton in Labour's cupboard about its record in office.
The hon. Member for York said that the NHS budget has always increased in real terms year after year. That is not true. Under the last Labour Government, the NHS budget was cut by 2.8 per cent.—it did not grow by 3 per cent.—in real terms in 1977–78. Labour's record is worse still. In 1979, under the last Labour Government, health expenditure was lower in real terms than it was in 1976. Three years on, as a result of the cut imposed in 1977–78, health expenditure was down in real terms from what it was in 1976. The skeleton in Labour's cupboard—I understand why Labour Members do not want it to be revealed—is that, during the last three years it was in office, it failed to deliver what my right hon. Friend the Prime Minister has pledged we will deliver during the next five years of Conservative government, as we have done for the past 17 years.

Mr. Smith: The Secretary of State ignores the fact that, in the five years of that Labour Government, the overall real-terms increase in national health service expenditure was 16 per cent., which is better than this Government have achieved in the past five years.

Mr. Dorrell: The hon. Gentleman glosses over the fact that expenditure was lower in real terms. In the three years from 1976 to 1979, the NHS did not grow, and that was not the only cut made between 1974 and 1979.
The Leader of the Opposition said that we should look at Labour's record. I have been looking at the Labour party's record in office, and it is quite instructive. It uses fine words about the health service, but it cut nurses' pay by 3 per cent. in real terms. What party builds a future for the national health service on a real-terms pay cut for nurses—and, furthermore, a real-terms pay cut for doctors of 31 per cent? When Labour was in office, there was 31 per cent. less than inflation for doctors. No wonder Labour is not keen to pledge itself to real-terms growth.
It is a matter not just of money, but of how the health service should be managed. If the Labour party is at sea on the issue of money, it is in the middle of the ocean on the question of how the health service should be managed.

Mr. Simon Hughes: I entirely agree with the Secretary of State's last sentence. When the Prime Minister made a


commitment at the Bournemouth conference that money for the NHS would rise to keep pace with costs year on year, was that commitment to keep pace with national inflation, or to keep pace with inflation as it affects the health service, which for the whole period of Conservative government has been greater than average inflation across the economy? To which of those two figures did the commitment relate?

Mr. Dorrell: As every taxpayer knows, we pay tax in pounds, not in NHS pounds. We are talking about real-terms growth in pounds corrected for inflation. That concept applies to the economy as a whole, and not to a specific part of the economy.

Several hon. Members: rose—

Mr. Dorrell: I shall make progress, and give way again later.
I want to get on to the issue that is of great interest to people working in the health service. If the hon. Member for Islington, South and Finsbury were ever to be responsible for the health service, how would he want it to be managed? He is fond of the soundbite: he used that device again this afternoon when he said that Labour would abolish the internal market. The problem is that he also uses another soundbite, which is that he is in favour of the purchaser-provider split. He sometimes uses both soundbites in the same paragraph.
The problem for anyone trying to understand the Labour party's policy is that those two phrases have precisely the same meaning. The hon. Gentleman is in favour of one description of the present state of affairs, but is not in favour of the other description of it. What kind of a policy is that?
The hon. Gentleman is clear about the purchaser-provider split. In an interview with John Humphrys on the "Today" programme, he was asked:
But you would still keep this split between the purchaser, the health authority, and the provider, that's to say the hospitals"?
The hon. Gentleman replied:
It is sensible to have a distinction between the people who plan and order treatment and the people who actually provide treatment.
He could not have been clearer than that.
The hon. Gentleman was merely confirming Labour party policy, which was set out in the policy document "Renewing the NHS." The document states:
There will be a clear distinction between the commissioning process … and the delivering process—using budgets within those services to meet needs.
Again, it could not be clearer.
The policy document goes on to make another important point. It states:
Health authorities will have agreements with different local health services and will have choice as to where to place them to suit patient needs.
The document is crystal clear. The Labour party is in favour of the purchaser-provider split and of purchasers having a choice between different providers to reflect patient needs. That could not be clearer.
The document states that
between the purchaser and provider

there would be
a long-term comprehensive health care agreement".
The Labour party does not like the word contract, but prefers the phrase,
a long-term comprehensive health care agreement".
Why use one word when five will do? However, the concept is the same. Despite repeated assertions to the contrary by Opposition Front Bench spokesmen, the Government are not committed to annual contracts for everything. I have repeatedly said that I am in favour of long-term contracts if there is a case for them in a particular context.
The Labour party's policy documents are clear: it is in favour of a purchaser-provider split with the purchaser having the freedom to make a choice that will reflect patient need. The problem for the hon. Gentleman is the role of general practitioners in that process. The Government's position is crystal clear: GP fundholders have the power to place contracts; if the GP is not a fundholder, the health authority has an obligation to listen to the GP, but when a contract is placed referrals must be within that contract.
Opposition Front Bench spokesmen are in total confusion. They say that they are in favour of GPs having a say in where long-term health care agreements should be placed. The hon. Member for Peckham was clear about that when she spoke to health service managers. She said that such agreements
will not be concluded without the involvement and consent of local GPs",
but that
when the local plans have been agreed GPs will have to work to local strategies.
The Labour party wants long-term care agreements to have teeth—very blunt teeth, it seems. In speeches made at the same time, Labour Members repeatedly asserted that a GP must be free to refer his or her patients anywhere in the country.
What Labour's health policy amounts to is that purchasers should have the freedom to place agreements to reflect patients' interests, but GPs should be free to take no notice of agreements that health authorities have been paid to negotiate. The hon. Gentleman should decide which of his two soundbites he wants to run with: is he in favour of the purchaser-provider split and of the internal market, or is he in favour of abolishing the internal market, putting the health service through another round of management upheaval and having a different model of health service management? He cannot fudge this issue: he must come clean.
In his speech, the hon. Gentleman did not even address the central question of the management of the health service, and he repeatedly refuses to do so. When I gave him the opportunity, he refused to deal with the other key issue relating to the management structure: the future of fundholding. Fundholding is the means by which we allow GPs to refer their patients directly where they choose. The Labour party has still to make its policy clear, although every policy document commits Labour to replacing fundholding. It tries to draw a distinction between replacing fundholding and abolishing it. No doubt my hon. Friends will tease out the difference between those two concepts, but I do not propose to detain the House any longer on it.
The Labour party is irrelevant, because it has nothing to say about the future of the NHS. It is widely recognised by those who have analysed them that Labour's policy statements are contradictory: they say one thing, then they say the opposite. They offer no vision of the future of the national health service. That is provided by the Government. Last week we published our White Paper, which sets out clearly the principles on which the NHS is based. It addresses the issues that politicians are said to be frightened to address. Can we afford the NHS? How does the NHS decide priority setting? When have we heard a speech from the Opposition Front Bench about any of those issues?
The White Paper also sets out the agenda with which the NHS must now deal. I am told that we do not publish legislation; the only flaw in that argument is the fact that I published a piece of legislation this morning, which sets out a future for a different contracting model in the primary care sector. I look forward to hearing the reaction of the hon. Member for Islington, South and Finsbury. The proposition that the Government do not have a clear view about the future of the health service as a whole and, in particular, the future of the primary care sector, is the result of Labour's applying to the Government a criticism that properly applies to itself.

Mr. Spearing: Will the Secretary of State give way?

Mr. Dorrell: No, I will not.
In their White Paper, the Government have set out a clear route to the future of the national health service, converting into substance and reality the one thing said by the hon. Member for Islington, South and Finsbury with which I absolutely agree. I refer to the founding principle of the national health service. In this country, we believe that health care should be available on the basis of the patient's clinical need, without regard to ability to pay. That is the key principle on which the national health service was built, and I believe that those who are committed to it have a clear obligation—a clear duty—to show how that high aspiration will be converted into reality. That is the duty that Opposition Front Benchers have failed to discharge.
The NHS deserves better of the Opposition's health spokesman than we have had this afternoon. It is increasingly clear that we shall not get better from this bankrupt Opposition, and that we have not the slightest chance of seeing from them a clear path to the future of the national health service.

Mr. Llew Smith: I represent an area that is generally regarded as being the birthplace of the national health service. Indeed, my predecessors include not only Michael Foot but Nye Bevan.
My area also has some of the worst health problems in the United Kingdom. The number of deaths from cancer, respiratory diseases and heart disease are well above the national average. The 1991 census for Blaenau Gwent showed that 41 per cent. of households included someone who suffered from either a long-term illness or a disability, and in 1993 the social services department had 4,000 people registered as disabled. On top of all that, we have the worst mental illness problems in Gwent. Ours is also one of the poorest areas in Wales—a fact that even the Welsh Office recognises.
A Gwent health survey carried out between 1985 and 1989 confirmed that the most deprived parts of the county experienced the worst health. That conclusion is not peculiar to Gwent: it has been reached time and again elsewhere. If we are to tackle bad health, we need not only a first-class health service but to be successful in combating poverty.
I want to concentrate on Gwent health authority, Gwent Community Health NHS trust and the South and East Wales Ambulance NHS trust, which do not seem to care about, or act in response to, the problems that I have described. I will deal first with Gwent health authority. Let me say at once what the authority is good at: it is good at producing one glossy magazine after another, filled with promises that it has no intention of keeping. For example, Jeremy Hallett, who until recently was chief executive of the authority—before, to put it politely, securing a job for one of his colleagues and then doing a runner to a nice little earner in another authority—stated in one of those glossy magazines:
Sharing responsibility is more than a quick fix consultation exercise. It must be about developing a long term relationship".
He went on to say:
To no small extent community involvement has become conventional wisdom because we have been seen to make them work in Gwent to the great benefit of local people.
Lindy Price, chairperson of Gwent health authority, stated, again in one of those many glossy magazines:
I would like to develop a culture of working together in the trust and county boroughs, with all general practitioners and community health councils
and
the general public when they are patients and when they are well".
All those statements are rubbish and no more than a public relations stunt: the authority has continually treated my constituents with total disdain.
Although everyone accepts that we have major health problems in Blaenau Gwent, Gwent health authority's response has been to cut the number of doctors. Most people would assume that the response to such problems should be an increase in the number. For example, in Cwm, near Ebbw Vale, the authority advertised for a replacement for a doctor who had resigned; instead of appointing another doctor, however, it merely handed over the patient list to another doctor already practising in the village. After a public outcry, the authority retreated, announcing that another doctor was to be appointed, but many local people thought that it would not happen—that it was just a publicity stunt to placate them. I did not believe that at the time, but I do now. I accept that the health authority was deliberately deceiving our people. But those people have no intention of sitting back and accepting the deception: they will continue to fight until they get the justice that they deserve. I hope that the Minister will investigate the health authority's deception, and the way in which it deliberately misled those with the greatest health problems.
I am not surprised at the incompetence of Gwent health authority and its failure to respond to health needs. One has only to look at some of the appointments to its board. An executive from the Midland bank was appointed recently. I look forward to the time when nurses, ancillary workers and doctors are appointed to the board of that bank, although I suspect that it will not happen in the foreseeable future.
Then we have the South and East Wales Ambulance NHS trust which under the previous chief executive and board decided to organise shopping trips to France in an attempt to generate income. I do not expect the trust's members to know everything, but in the circumstances I would have expected them to find out first whether there was a bank holiday in France and whether the shops would be closed. However, that was obviously too much for the chief executive and senior staff, because when the trippers arrived the shops were closed. The trust was then forced to repay the cost to the trippers, together with compensation.
Never short of ideas, the trust then decided to invest £125,000 in another computer control system, which has still not been made to work. I suspect—I may be wrong—that it may have used that system to organise the trip to France. That seems logical.
Not satisfied with those disasters, the trust decided to invest £3.6 million in new headquarters, which it now accepts was an overspend of 50 per cent. It told the Welsh Office that the cost would be £2.4 million, although the directors knew at the time that it would be £3.1 million, and the actual cost was even higher.
After all that—and much more—the non-executive directors are still in place. Will the Minister investigate and find out why that is? In the mean time, ambulance cover is being cut and morale is at a low ebb. I could give one example after another of the trust's inefficiency, but I will give just one more. The trust spent £350,000 employing consultants to cut transport costs. The cuts still have not reached more than one third of that figure, so that was not good value for money for taxpayers.
Bob Hudson, chief executive of Gwent Community Health NHS trust, decided to reorganise mental health provision for people in a part of my community without consulting patients, their families, friends, nurses, doctors or anyone on the local authorities. When we protested about that in meeting after meeting, Mr. Hudson's response to the most vulnerable people in our community was:
Well folks, you've lost out".
He then told us that he could not make the next meeting as he had decided to go on holiday in Ireland, and that in any event there was no chance of altering the plans. Consultants attended the next meeting, where the plans were totally changed and it was obvious that the reason was based on medical advice as opposed to advice from managers and senior administrators.
I mention those examples—I could mention many more—to highlight the incompetence of Gwent health authority, Gwent Community Health NHS trust and the South and East Wales Ambulance NHS trust, and the uncaring attitude of their senior people. They do not understand, care or have a commitment to the NHS. To them, it is just another way of making a quick buck. Their promises in those glossy magazines were just words—a publicity stunt.
I hope that a future Labour Government will examine those people, who are in senior positions in the health authority and on the board, and start replacing them with people who understand the service, who care for it and who know what is required to make it better. We must

reject the philosophy of the NHS as a business and develop it into what Nye intended: a service, and a great service at that.

Sir Norman Fowler: At the beginning of the debate, the hon. Member for Islington, South and Finsbury (Mr. Smith) referred with approbation to many quotations about the so-called "crisis in the health service." He gave a further quote, that it was "close to collapse", and said that it was in the "worst position for many years".
Other press cuttings assert:
Crisis has become an uncomfortable way of life for the health service".
They even assert that the "NHS faces collapse". The Times asserts:
Patients are suffering and the wait for an appointment is lengthening into months, and even years".
Those are serious charges. Those phrases are almost identical to the phrases used by the hon. Member for Islington, South and Finsbury. The difference is that those press comments were made in 1975, not in 1995 and 1996. The same sort of comments as the hon. Gentleman made and the same sort of quotations as he used were made in 1975, 1976, 1977 and 1978 under the last Labour Government. In 1975, the Labour Government had to bring in an outsider, Lord Goodman, to sort out the mess in the NHS.
My first point—I make it with some humility—is that a certain amount of care is necessary when talking about the state of the health service. Anyone who seriously believes that the election of a Labour Government would transform the health service's internal morale is not only deceiving himself, but arguing against all historical evidence. In the past 50 years, disputes in the NHS have been entirely politically neutral. If—God forbid—there were to be a Labour Government, that would not mean an end to disputes in the health service. No hon. Member seriously believes that. If they do, they should not be Members. The British Medical Association and the health unions would continue their attacks and continue to press for more resources.
Let us try, therefore, to get away from dangerous nonsense that the NHS in some way faces collapse. It is not true of the NHS today any more, frankly, than it was in 1975. In the past 17 years, there has been a successful development of the NHS. No one would claim for a moment that there have not been problems, but the development has continued.

Mr. John Gunnell: Does the right hon. Gentleman agree that it was not until the present Government's so-called reforms that trusts operated their budgets individually? Inevitably, those trusts have found themselves running at a considerable deficit. One of the trusts in my constituency is talking about an £11 million deficit this year. Therefore, we are talking not about the service as a whole, but about particular parts of it. The people in that service feel that it is on the point of collapse because they consider the budgets and the need to be met, and they know that they cannot meet it.

Sir Norman Fowler: I am grateful for the hon. Gentleman's statement that we are not talking about the whole of the NHS. I will make a specific point about NHS trusts that is the exact opposite of his point, but I am glad that at any rate some sanity is beginning to reassert itself in the general debate on the health service.
However we measure it, in the past 17 years more resources have been devoted to the NHS, more patients have been treated than ever before, and more new hospitals have been built. I do not remember receiving a reply to my question to the hon. Member for Islington, South and Finsbury, who leads for the Opposition, about capital cuts in the 1970s. Waiting times have come down and nurses' pay has improved. The Government gave them a Nurses and Midwives Pay Review Body, which the profession had wanted and which has had a profound effect on the pay of nurses throughout the service.
In addition, the Government have made a commitment on the health service's future funding, which compares starkly, as anyone who has listened to the debate would agree, with what is coming from the Opposition Front-Bench team. I hope that, before the Opposition call another supply day on this subject, we might at least receive some replies to the questions of my right hon. Friend the Secretary of State for Health.
The hon. Member for Morley and Leeds, South (Mr. Gunnell) raised a point about the trusts. One of the trusts' impressive features has been the way in which they are now able to respond quickly to some of the problems in the health service. We deceive ourselves if we think that there will never be problems in the health service. Twelve months ago, my local hospital of Good Hope in Sutton Coldfield was at the centre of a storm. There was a great dispute about waiting times and patients waiting on trolleys. What has been impressive is the way in which the dispute has been handled, thanks particularly to my hon. Friend the Under-Secretary of State for Health. We now have a new reception area, a new ward for receiving accident and emergency patients and two new operating theatres. That is the impressive way in which the trust has responded.
I do not say to the hon. Gentleman that, in some miraculous way, this is going to guarantee for all time that there will not be problems and crises. No one can guarantee that. Let us be adult about that and accept it, but the new facilities have had a profound effect on morale in the hospital. Anyone who visits it will understand and recognise how much they are welcomed.
I should like to deal with the central point of this debate, and to concentrate on the section of the Opposition's motion that the hon. Member for Islington, South and Finsbury rightly concentrated on, as did my right hon. Friend the Secretary of State for Health. It states:
That this House reasserts its belief in the fundamental principles of the National Health Service … that health care should be available to all, based on need and not on ability to pay … and seeks to restore the ethos of the NHS to that of a public service, not of a commercial competitive business.
That brings us to the crucial and persistent charge made by the Opposition against the Government for the past 17 years: that we are somehow concerned with moving away from the principle that health care should be available to all, based on need and not on ability to pay, and that we are concerned with—although I welcome the fact that, for

once, the hon. Member for Islington, South and Finsbury did not use the word—privatising the health service. That is arrant nonsense, but it has not prevented the scare from being run, year after year and in every election in which I have taken part since 1979.

Mr. Bayley: During the time the right hon. Gentleman was Secretary of State for Health, the NHS provided long-term nursing care free. If one needs long-term nursing care now, it is necessary to go to the private sector and to private nursing homes. It is no longer a free service: it is a means-tested service.

Sir Norman Fowler: I am grateful for that endorsement of my period in office, although that fact did not prevent my being attacked—just as every Secretary of State responsible for the health service has been attacked—for wishing to privatise the NHS. I remember that on one Saturday morning in 1983 the Opposition had published a "leaked" copy of a "secret" Health Department report planning the privatisation of the health service. Those reports are always secret, and they are always leaked. Michael Foot called it
the most serious attack on the NHS since it was originally started.
That does not exactly understate his opposition to my policy. The only trouble was that neither I nor the Minister for Health could remember precisely which leaked report Mr. Foot had in mind.
It subsequently became clear that Mr. Foot had in mind a consultation document published under the very threatening title, "Co-operation between the NHS and the private sector at district level" and containing such threatening ideas as allowing NHS patients access to underused high-technology equipment in the private sector. In short, the radical idea that was so attacked by the Opposition was that of co-operation between the sectors. The idea was that resources were out there which, whether they were labelled "public resources" or "private resources", they could be used for the good of patients—an entirely sensible policy which I hope and believe that Ministers are developing.
The only sensible meaning of the charge of privatising the health service can be that we intend to change the entire basis of financing the health service and that we are intent on moving it from an essentially tax-funded service to one based on private health insurance. However, surely the only significant point of that debate is that that option has been rejected by every Conservative Secretary of State responsible for health since 1979. It has been rejected by successive Conservative Cabinets. It has been rejected explicitly, in his latest White Paper, by my right hon. Friend the present Secretary of State for Health. It was rejected by Lady Thatcher, and it is most certainly rejected by my right hon. Friend the Prime Minister. We are committed to a tax-funded service. Moreover, we are committed to providing real increases in its resources to an extent that, up to now, the Labour party has not even dared to hint at.

Mr. Simon Hughes: I accept those two commitments, but does the right hon. Gentleman agree that if the percentage of those using private health insurance continues to increase—it is currently 11 per cent. and


projected to be 14 per cent. by the end of the decade—we shall have privatisation of the UK health care system not by intention but by fact?

Sir Norman Fowler: That is not privatisation in the remotest sense, whether by intention or by fact. Let us turn the situation around. If the Liberal party wishes to say that it will abolish the private sector in the NHS, let it do so, but I do not think that 14 per cent. is an extraordinary percentage. We believe in freedom of choice. If the Labour party or the Liberals wish to say that that is not their policy, let them do so. Up to now, however, they have not done so. I will let the hon. Member for Southwark and Bermondsey (Mr. Hughes) make his own speech—he has a wonderful habit of making speeches during the speeches of other hon. Members—but I would like to have their position explained.
We are also committed to achieving the very best value for the taxpayers' money that we use, which also distinguishes us from the Opposition. The real difference between us and the Opposition is in this sphere. We are committed to the NHS as a public service, which does not mean that everyone in that public service has to be employed directly by the NHS. Opposition Members seem to think of the performance of the health service, and perhaps of public services generally, in terms of whether it directly employs all its work force. That is why the Opposition have consistently opposed, for example, the initiatives taken in contracting out services.
The reason for contracting out ancillary services is clear enough, and the policy—which is not in the least controversial—is followed by other service providers and by virtually every other major industrial company in the United Kingdom. The case for it is simple. They have found that specialist companies outside can often provide a better and more cost-effective service than an in-house provider. The fact that we want to use contracted-out services certainly does not mean that we want to privatise the health service.
I am sceptical about the Opposition's new-found enthusiasm for attacking bureaucracy. If more can be done in delayering the health service, I should be very much in favour of it—although I realise that my right hon. Friend the Secretary of State for Health is already promising £300 million in savings from administrative reforms. The real scandal of bureaucracy, however, occurs when responsibility is shuffled from one administrator to another, when no one takes responsibility, when no one knows where the buck stops, when difficult decisions are avoided and when decisions are for ever delayed in cumbersome committees. That is why, in the 1980s, we acted to introduce general managers into the NHS—so that the buck would stop somewhere. The reform was, of course, fought all the way by the Labour party, but we introduced it in the teeth of Labour opposition. That reform is one of the reasons why decision making in the health service is better today and I hope that Opposition Front Benchers will accept it as a permanent piece of policy for the future.
We should recognise that all parties are basically agreed that the future of the health service is as a tax-based service. There is no dispute about that. The real debate should be about which party can provide the strong

economy that is necessary to provide a strong health service. That is the addition to the argument—it must be. Although the hon. Member for Islington, South and Finsbury criticised the Chancellor for making that obvious point, it is clear and obvious that without a strong economy and strong financial policy, the health service would suffer. It may be reassuring for some to say that all that is needed is the stating of priorities, but history shows that that is not so. The matter is not simply one of making statements. When the Labour Government cut the hospital-building programme—and it was, I repeat, a devastating cut—it was not because they wanted to do so, but because they were forced to do so due to the collapse of their economic policy.
The judgment that the public need to make relates to health service performance and health service commitment. On those two matters, the Government have nothing to fear. The public also need to judge economic policy because without a successful economic policy, pledges and promises are frankly just words.
For six years, I was the Secretary of State for Health and Social Services. In that time, I acquired an immense respect for those working in the health service—whether nurses, doctors, managers or staff. The health service in this country provides the most cost-effective service of any health system in the world. Of course, at any stage in the past 50 years a case could be made for spending more money. That has been so for any Government at any time, but it should not disguise just how well and effectively the NHS has performed, especially over the past 17 years.
I would never remotely support privatisation of the health service, but that is not a real issue. The Government have made their commitment to the NHS crystal clear. It is because of the Government's commitment and record that I shall support the amendment tabled by my right hon. Friend the Prime Minister.

Mr. Bernard Jenkin: On a point of order, Madam Deputy Speaker. You will be aware that earlier today a number of hon. Members raised the issue of an apparent slur on the Cabinet Secretary and on the impartiality of the civil service. Since then, the Cabinet Office has issued a statement claiming that the Evening Standard story is "a travesty". Is there any way of bringing those hon. Members back to the House to apologise to the civil servants who have been drawn into a political controversy in a completely unwarranted manner?

Madam Deputy Speaker: It is my understanding that Madam Speaker indicated that the matter was not one with which she could deal. The matter must be dealt with in some other way.

Mr. Simon Hughes: I am very happy to follow the speech of the right hon. Member for Sutton Coldfield (Sir N. Fowler). His speech should be read widely, because it reinforced the view that the national health service is not the property of any one political party and has not been supported or, indeed, encouraged only by any one political party. It has become part of the fabric of British life. Providing a health service is one of the things that we do best. It is certainly a hugely cost-efficient and effective way of delivering health care.


The right hon. Gentleman's stewardship of it was extremely responsible and committed. I have some minor quibbles with him, but, in general, his job was handled very securely.
It is welcome that it became clear in the White Paper—which, to be honest, was not really a White Paper, but came out under such a title—that was published last week, that the Secretary of State reinforced without qualification the view that not only should we have a tax-funded NHS, but we can afford it. I hope that the one message that comes out of the debate is that there is no threat to the existence of the NHS from some specious belief that large numbers of older people will make it unaffordable. In fact, I would argue that paying for a good health service is not undermined by an argument that older people are more disadvantageous to society. The NHS is as likely to be as affordable in the lifetime of every hon. Member as it has been in the past.
Like the Secretary of State, I welcome a debate on the NHS. I welcome an opportunity to pay tribute to the service, to praise those who work in it and to say how good I believe it is. It serves hon. Members and our constituents extraordinarily well. Of course, things go wrong and sometimes there are sad mistakes and tragedies.
I also share the Secretary of State's view that the Labour party has made an extraordinary choice of subject for the debate. Nye Bevan would turn in his grave at the lack of the Labour party's financial commitment to the health service. As somebody who was brought up in south Wales and who shares and understands Nye Bevan's commitment to the health service, I understand now the problems that he said he had in the 1940s.
In 1942–43, when Beveridge wrote his famous report and said that the precondition for a welfare state was a health service funded by the taxpayer, Nye Bevan supported that view, but had the greatest difficulty in persuading the Labour party to agree until well into the beginning of the 1945 Government. After the implementation of the Beveridge report, in the period at the end of the war, from 1943 to 1945—at the time Beveridge was not a Member of Parliament, but became a Liberal Member of Parliament in 1945 and a Liberal Peer thereafter—Nye Bevan said:
It is a form of torture unknown to the ancients … to convert the leaders of the Labour Party … to recapture territory occupied by Beveridge … I can sympathise with that fellow Sisyphus and his bloody boulder".
For all sorts of reasons, the Labour party found it difficult at first—there were many objections—to accept the whole idea of the welfare state being predicated on a national health service. It came round to the view, thank goodness, voted for it and put it in its post-war programme. We supported Labour, the Tories opposed it, but now there is unanimity.
The Secretary of State, the hon. Member for Islington, South and Finsbury (Mr. Smith) and I were pre-recording a Granada Television programme last week—which, coincidentally, is going out tonight in the Granada region—during which someone from the audience asked whether we could please reach all-party agreement on the health service and have less party politicking on it. I endorse that view. Out there, the public are fed up with our trying to score silly points on the health service and want us to take it back into common ownership and to make as many common commitments as possible.
The right hon. Member for Sutton Coldfield is absolutely right. The precondition for a successful health service is having the necessary money to spend on it. It will need more money, because demand is growing. Paradoxically, the better the health service and the more successful primary care, the more demand will grow. At the moment, demand is growing quite strongly.
Whatever the success of the economy, however, the public will always need to know the respective parties' specific commitments for the coming Parliament. Today, the Government have said that, year on year, funding will keep pace with inflation, although not NHS inflation, and all we have heard from the Labour party is a commitment to make £100 million-worth of bureaucracy savings. My colleagues and I are now in the position that we have made a simple budgetary decision to commit a significantly greater amount than either of the other two parties. I shall address the fact later that this may mean that taxes would not be cut.
Unarguably, there will be difficulties in the national health service this winter. The sequence of events went something like this: in the run-up to the autumn, no public figures were available on what the difficulties would be. As the NHS did not produce the figures, my office calculated that the shortfall this year in the health authorities in England would be at least £133.4 million, of which about £55 million came from the two Thames regions.
In October, the British Medical Association estimated that £200 million was needed. The National Association of Health Authorities and Trusts said something similar. The Government then produced their figures, in response to the hon. Member for Newham, South (Mr. Spearing), which stated that the shortfall would be about £122 million. I do not pretend that that figure is cast in stone. I accept that it will change as the year goes on. However, I know that health authority after health authority and trust after trust are really worried about what will happen this winter. The problem exists because last year we overspent what was allocated and the extra money was taken out of this year's budget.
The first issue on which I should like a response from the Government—the Secretary of State knows that I am concerned about this—is that, whatever the final arrangements for the Chancellor's Budget announcement next week, which, we understand will include a welcome increase in funds for the health service, some money needs to be made available for this winter. If that money is not made available, some people will be turned away from hospital doors and told that they cannot be treated, waiting lists will increase and there may well be tragedies that certainly should not happen.
I should like to add a postscript to that. It must be a long-term objective of the health service, if not a short-term objective—long-term should mean a few years rather than just a few months—to arrive at a situation in which we do not have mixed wards. Beyond that, we should aim to have no wards. Hon. Members may not be aware that in America—a country that we often castigate for having a lousy health service—wards have not been known for 40 years. Everybody has their own room, whether they are on Medicare or Medicaid or go through the insurance-funded system. We must move towards this more civilised system for acute treatment.
I have a second specific issue on which I should be grateful for an answer. A reply from the Under-Secretary of State for Health, the hon. Member for Orpington (Mr. Horam), to a written question from me published in today's Hansard, contains the most extraordinary figure, revealing that the national health service needs £2.4 billion for its repair backlog. That is the Government's figure. It has increased by 40 per cent. in the past five years. The backlog in one region—Trent—has doubled in that period from £102 million to £200 million. While pursuing the private finance initiative, the Government have left a lot of hospital stock to rot where it stands. We need a significant amount of money to begin to catch up with the NHS repair backlog. That is an unacceptable situation, meaning that many places have poor buildings that are not likely to be replaced in the near future.
I should now like to make one regional point and one south London point. It is clear that London health authorities will have acute deficit problems this year and next. East London and The City health authority—hon. Members from that area are present today—and Merton, Sutton and Wandsworth health authority have significant projected deficits of up to £17 million. My local health authority, Lambeth, Southwark and Lewisham—it is also the local health authority of the hon. Member for Dulwich (Ms Jowell), who speaks for the Labour party on health—has a projected deficit of £19 million for next year. I think that the hon. Lady agrees that it would be unacceptable for our health authority, serving the second most deprived area in the country, to have a settlement that forced it to cut £18.8 million out of next year's budget. That cannot be done without significant adverse effects. I have it in writing that the maximum waiting times for routine in-patient and day care treatment for our residents have already increased, as the hon. Lady knows, from 12 months to 18 months. They are likely to increase further. Those waiting times will not go up to the same extent for the patients of fundholding GPs, who have the advantage that that part of the two-tier system delivers.
I have a plea. This is not a partisan point; it is a view informed by professionals who work for the health authorities. We cannot sustain the present level of service on the present level of funding. The Government must come up with more money. That is the most important issue that we should be concerned about.
I am also concerned that the health service is becoming increasingly fractured as a result of breaking everything down to trusts and health authorities. The best example of that is locally negotiated pay. People no longer feel that they are part of the NHS if they have to negotiate locally. It is also inefficient, costing probably as much as £40 million or £50 million extra a year because professionals have to stop their radiography or physiotherapy to attend local pay negotiations.
There is clearly a lack of regional strategy. The health service would be on a much more secure footing if we had proper, democratically elected regional health authorities that could plan strategy, rather than competition between one provider and another.
I believe that the Secretary of State and Ministers accept that there is, in effect, a two-tier health service. There is a difference between those who go through the

GP fundholding route and those who do not. Providers need to advantage GP fundholders' patients in many cases because otherwise that business might go elsewhere. They are less concerned about favouring the large bulk contracts from the local health authority. Patients of fundholders therefore jump the queue. That is not a fair system. If the principles enunciated by the former Secretary of State, the right hon. Member for Sutton Coldfield, and by the current Secretary of State — principles that are also contained in the wording of the Government amendment —are to be upheld, equality of access must mean equality of access and must not depend on a patient's GP.
The final aspect of the health service that is clearly not working is the time spent on the bureaucracy of the annual contracting round. I was interested and grateful to hear the Secretary of State say that he was willing to consider moving to longer-term contracts. I hope that we can persuade the Government that it would be better for three-year contracts between purchaser and provider to be the norm. Obviously, there must be adjustments year on year, but the substantive contract should be for three years, not one year. It may even be possible to have longer contracts. That change, together with national rather than local pay negotiations, could save significant amounts of money.
I have one other short point to make before my concluding remarks. One priority identified in "The Health of the Nation"—there is no dispute on this and it is not a party political matter—is that we should put more emphasis on mental health services. In some areas, it is very difficult to receive treatment for mental health needs in the community or in hospital. In the same way that justice delayed is justice denied, care delayed can often be care denied or care altogether too late. We must put mental health in the same league as physical health. We are all as likely to be as vulnerable to a failure of one as we are to that of the other. That should not be a matter for dispute.
What would the public like to hear from politicians as a result of today's debate, next week's Budget and the forthcoming general election? I think that they would like a year-on-year commitment to keep up with real terms spending. The Secretary of State was honest when he said that the increase was to keep pace with inflation. It is not true that there is not differential inflation in the NHS. There is. It is also true that it has been greater in the recent past. It may not always be greater—it has been coming down—but we cannot claim to make a commitment to real terms growth if that commitment is not to real terms growth in the health service, should that be greater than inflation. On the Chancellor's Red Book projections, unless there is significantly more money next year, we shall go below a real terms increase for the first time since 1979.
We also need, if humanly possible, to halt the closures resulting from the short-term cuts this year and next year. Those finance-driven closures—they are not strategically planned—of beds, wards, hospitals and clinics must be prevented. The only way to do so is to find the funds so that health authorities do not need to save the money by closing facilities.
We need more staff in the NHS. As a party, we are happy to pledge £200 million a year. which would buy the equivalent of 10,000 nurses or 5,000 doctors. We desperately need them. In parts of the country, the service is crying out for general practitioners and in some places it cannot get nurses or midwives. We should aim to reduce


waiting lists to six months within three years. It is achievable, but more resources are necessary—probably about £150 million a year. We have made that commitment.
Finally, as well as preventive measures such as restoring free eye and dental checks, which we should never have taken away and which can be funded by putting extra tax on tobacco and cigarettes, which we support, we have to make a commitment to ensuring enough general funding for the health service. It is no good relying on bureaucracy savings. Of course, there can always be savings on bureaucracy, but those are not enough.
On behalf of my colleagues and the majority of the people, I must make what might be my last plea to the Government before the Budget. They should renounce the tempting, pre-election bribe of, "Let's cut taxes." I am sure that the public want a fair tax system, with higher earners paying more to fund the public services.
As for the Labour party, I am sad that Labour Members make it a tale of some sound and a little fury, signifying almost no coherent policy and almost no funding. They have offered no answers to any of the funding questions. If they want to be credible before the election, they have to persuade the shadow Chancellor to put his money where their foot is—in their mouths. The Labour party needs to make some proper financial commitment to the health service, or it will be justifying the fears of Nye Bevan. He may have anticipated that the Labour party would not necessarily be able to guarantee the funding that the health service needs.
The public want us to make commitments across the Floor of the House. I welcome the Government's commitments, as far as they have gone—they must go further. The Labour party has to start to show what it is made of.

Mrs. Marion Roe: First, I must congratulate my right hon. Friend the Secretary of State on his White Paper, "A Service with Ambitions". Like the chairman of the British Medical Association council, Dr. Sandy Macara, I welcome the document as a commitment by the Government to the continuation and development of a comprehensive and truly national health service. It is appropriate that, following the implementation of the reforms of the early 1990s, a focus is given to delivering a better quality of NHS care year after year, and I am sure that we would all endorse the Government's far-reaching ambitions for the national health service and the steps that they believe must be taken if they are to be achieved.
I also want to place on record a welcome for the Prime Minister's health guarantee, which he gave at this year's Conservative party conference, when he pledged that the next Conservative Government would increase the real resources available to the NHS every year for the five years of the next Parliament. I therefore believe that, under a Conservative Government, the NHS can look forward to an excellent future.
Unfortunately, when I intervened on the Leader of the Opposition during the debate on the Queen's Speech a few weeks ago, inviting him to match the Prime Minister's pledge, he refused to do so. Not only that, but it would appear that the Labour party is unable to give any policy commitments, either.
I have listened carefully to the contributions to the debate and I fear that the Opposition parties seem to prefer always to give the impression that the national health service is terrible, that patients are being neglected and ignored, and that there is always a crisis around the corner. That is a slur on all those who are working within the health service.
A few months ago, I conducted a survey in my constituency and found that, of those who responded to the 38,000 questionnaires circulated, just under 80 per cent. treated by the NHS within the past two years were either satisfied or very satisfied with their treatment. Of those who were dissatisfied, the complaints were mostly minor, and have since been addressed. Over and over again, the high quality of care was remarked upon.
One reason is that there is no doubt that East Hertfordshire NHS trust, which serves my constituents, has progressed enormously since achieving trust status in April 1992. Its substantial achievements in patient services during that time exemplify the sort of developments throughout the country in recent years.
I have drawn attention in the House to the notable advances in acute hospital care that have benefited patients in east Hertfordshire as a result of the NHS reforms, which enabled local doctors, nurses and managers to meet health care needs swiftly, flexibly and with outstanding value for money. That increased ability to respond puts the NHS in a strong position to face the pressures of current demands.
It is undeniable that hospital services are under pressure, but nor can it be denied that the NHS has always worked under pressure, from its earliest days. As the demands on our health service have increased, so too have the ability and determination of our health workers to meet those demands. They are supported in this by the substantial improvements that the Government have made in the structure of our national health service—for example, the enormous advances in community health services in the past few years. Whether run by family doctors or by community trusts, community health services are vital to everyone. They are the services to which we all need access more frequently than any other.
In east Hertfordshire, we are fortunate to have a network of general practitioners who have used the freedoms and opportunities given them by recent legislation to provide vastly improved patient services. New and enlarged premises now give space and facilities for hospital consultants to come away from the large district general hospitals to see patients in their neighbourhoods.
Patients can see their hospital specialists in the familiar surroundings of their family doctors' surgery, close to home, at a time that fits in with their work and family commitments. They receive quick assessment, with the confidence that more comprehensive treatment will be made available to them back at the general hospital if it is needed.
GP fundholders have used the flexibility of holding their own budgets to pay for those services direct, as their patients require them. Many family doctors are also using their new potential to offer minor surgery and diagnostic facilities in their premises.
Since the inception of fundholding in 1991—for example, at the Stockwell Lodge medical centre in Cheshunt in my constituency—the level of secondary care


delivered in a primary care setting has gradually increased such that, at present, each month 20 new clinics are provided on the site in the specialties of general medicine, general surgery with two consultants, gynaecology, orthopaedics with two consultants, ear, nose and throat, psychiatry, psychology, dermatology, counselling, and ophthalmology. There are also six minor surgery lists, with four audiometry sessions, one coloscopy session and four ultrasound sessions.
That has all been achieved with a minimum saving of £250,000 in the year 1995–96, which is subject to review, with further considerable savings forecast in the next 24 months. The secondary benefits include shorter waiting times for all patients, fundholding and non-fundholding; the provision of services in an acceptable location; better communication between primary and secondary care doctors; and greater patient and doctor satisfaction.
In east Hertfordshire, the trust hospital and community services work closely with local family doctors to deliver those improvements. The continuing advances in the trust's community services are a further indication of the benefits that patients now enjoy on a daily basis.
For example, I was recently delighted to open the newly refurbished Waltham Cross community clinic, which represents a significant development in community services for people in my constituency and in east Hertfordshire. A clinic has been on the site, providing a range of services for local people, since 1938, but the major new development will enable patients to obtain a wider, more diverse range of services than before.
Services available include a multi-disciplinary child assessment team with a speech and language therapist; a consultant community paediatrician; and a physiotherapist and occupational therapist who will visit the clinic weekly. Audiology, family planning, chiropody, continence, dental, orthoptic, ante-natal and post-natal services are also available.
The clinic is one of the many community units being developed throughout Britain as our health services meet the challenge of the primary-care-led NHS. Local access is essential, especially for the elderly, the disabled, families with young children and those with mental health problems, for all of whom a long journey to a distant district general hospital is daunting and difficult, if not impossible. The clinic and others like it ensure that health care is much more easily accessible to all.
The Waltham Cross clinic scheme was approved in 1994, with money from the North Thames region that forms but a small part of the £40 billion spent on health services in the past year. Improvements in community services result not only from better premises but from a host of advances that the Government's initiatives are helping to create.
Further examples of benefits are listed in East Hertfordshire NHS trust's recent application for charter mark status—itself a reaffirmation of the Government's policy to provide objective analysis of achievements in public service.
Those benefits include the introduction of a maximum 15-minute wait for out-patient appointments in community clinics; Saturday clinics for working parents

who are unable to attend during the week; the introduction of a night nursing service; and an improved wheelchair service that will provide at the assessment clinic routine chairs that patients will be able to take away, thus providing an immediate benefit from visiting the clinic, before the customised wheelchair is delivered by the approved supplier within five to 10 days.
Among the further benefits listed are improved car parking, with facilities for wheelchair users and the provision of outside covered pram shelters and safety gates for small children; an improvement in the range of information available on a wide range of health issues; the introduction of a user committee to ensure that patients and their carers can contribute to the scrutiny and development of community services; a standard policy that, whenever possible, the needs of patients are given top priority and staff are encouraged to arrange appointments and visits that minimise disruption; and, finally, the development of a community child protection team, based in a community clinic to facilitate access for all staff and clients using the service.
There are examples throughout the country of the genuine benefits experienced by patients as a result of the Government's initiatives to improve the national health service. All those benefits have been achieved cost-effectively, with key improvements directed to patients' needs. In east Hertfordshire, benchmarking reviews show that all the improvements have taken place in an area where staff numbers are lower than average, but total patient contacts higher.
East Hertfordshire NHS trust is an outstanding example of how the Government's reforms, put properly into practice, can daily provide genuine improvements for patients.

Mr. John Heppell: My hon. Friend the Member for Islington, South and Finsbury (Mr. Smith) spoke about the good news club that has been formed by some Conservatives. It seems that every Conservative Member who has spoken today has been a member of that club, because the national health service they talk about is not the NHS that I recognise. The only time they talk about anything bad is when it is something that happened in 1975.
I remind those hon. Members that 1975 was 21 years ago; many of the people who will be voting at the next general election had not even been born then. Even if I accepted their criticisms about what happened in 1975—which I do not—I would have to tell them that it was a different health service then, at a different time, with different needs and different economic circumstances.
In the 21 years since 1975, we have had 17 years of the Conservatives in office. If the news is all good, why do we still have 1 million people on the waiting list, year after year? Why have 250,000 people been on the waiting list for more than six months? Why, last year alone, did almost 55,000 people effectively have their operations cancelled at the last moment? Nobody can tell me that that is good news.
I do not want to bandy national statistics with the Minister, because, whatever statistic anyone mentions, he will find a different one. The Minister is obviously a proponent of the idea that there are three types of mathematician: those that can count, and those that cannot. The penny will drop in a minute.
I want to talk about the reality of what is happening locally in my patch. The right hon. Member for Sutton Coldfield (Sir N. Fowler) talked about how trusts could respond quickly to events. He is right, and I know a good example of how they respond quickly—an article in my local paper, saying:
Cash crisis axes more ops … City Hospital and QMC' — 
Queen's medical centre—
are forced to postpone routine operations".
That is how they act quickly, because they are running out of money.
For November and December alone, the Queen's medical centre has postponed 350 operations that people were expecting. The city council has stopped all routine, non-emergency operations, because more emergency operations are needed than it thought, and it has effectively no contingency in its budget to meet the demand.
Unless there is extra money for Nottingham health authority, it is predicted that next year no medical equipment will be replaced. Plans to introduce the latest treatments and develop breast cancer services will be dropped. The waiting list for routine operations will grow even more. All high-cost treatments will have to be restricted. National standards for the ambulance service will not be met. There will be no contingency plans, because there will be no contingency fund; there will be no money.
The Minister may think I exaggerate, but these are not my predictions but those of the chairman of the Nottingham health authority, Sir David White, who is not a noted socialist. He was knighted by the Government. He is one of the kings of the quangos. The Government not only think that he is good enough to chair the health authority; he is on almost every conceivable quango for the Nottingham area. He is not noted for his criticism of the Government. However, he is publicly saying that all those things will happen next year. He says that part of the reason is that Nottingham has been underfunded for many years. It is funded at 97 per cent. of the average, when, because it is a teaching district, it should be funded at more than 100 per cent. The gap between 97 and 100 per cent. funding is £11 million.
The confusion in the Government about how to deal with the problem is interesting. In February, the Secretary of State agreed that there was underfunding, although of £9 million rather than £11 million. The hon. Member for Gedling (Mr. Mitchell), who has since become the Minister responsible for the Nottingham area, said that the underfunding dated back to the 1960s, and could not be solved overnight. I did not expect anyone to solve it overnight, but if it dates back to the 1960s, I should have thought that the Government might have tried to tackle it in the years since 1979.
That was not the end of the story. Only weeks later, the Prime Minister contradicted the hon. Member for Gedling, and said that there was no underfunding. He said that the health authority had made it up so that it could bid for more money. Within a week of the Prime Minister contradicting the hon. Member for Gedling, a junior Health Minister, the hon. Member for Orpington (Mr. Horam), said that there was underfunding, and that there was a battle to address a £7 million deficit this year. Finally, the Secretary of State agreed on 12 November

that there was underfunding, and gave a hint that some more money might be made available to the people of Nottinghamshire.
That is all well and good, but how am I to tackle the letters I get from people who have been told they cannot have operations? I want to be able to tell them who is responsible for the failure to give the public the service that they deserve. Who is responsible for ensuring that patients get treated and for looking after the sick? Should I tell them that it is the Government and the way that their policies have changed the health service that has put those people in that position?
Should I say that the health authority or the trusts have handled it badly? I have some difficulty with that, because many of the people on the health authority and the trusts are Tory placemen. They are guilty only of doing what the Government want—and doing it with enthusiasm. It is difficult to blame them entirely for the problem. The blame rests fairly and squarely with the Government.
If underfunding, which we have had since 1960, is the only problem that has caused the crisis in Nottingham, why have we not faced such a crisis before? Underfunding may be part of the problem but the real problem has more to do with the changes that the Government have made: the internal market and the growth of bureaucracy. The Government talk about increasing spending year year on year, but £1.5 billion is being spent, year on year on year, on extra bureaucracy. That money must come from somewhere, and it comes from services.
There are fewer doctors and nurses and more accountants and managers. Last year alone, there were pay rises of 18.5 per cent. for senior managers, while for nurses the figure was only 3 per cent. Many people in the health authorities and trusts have watched things going wrong for some time and have not spoken out.
That is what I accuse them of. They are guilty of complicity, of not making criticisms. They have not been willing to speak out until now. The hon. Member for Gedling said that the present position had not been reached overnight. It has been known about for years, and the authority managed to survive because of the reserves it built up before the Government made their changes.
One group that I do not want to criticise is health service staff. The nurses, doctors, auxiliary staff and ambulance drivers deserve praise, not criticism, because they have been putting off the crisis, and they are still putting it off in many hospitals. They have kept the NHS as good as it is—despite, not because of, the Government. The staff will have to bear the consequences of the failure of the Government, the health authority and the trusts. The financial pressures on Queen's medical centre, which is running a £1.6 million deficit, mean that staff have been told that, because the centre's budget is 70 per cent. of costs, many of them may be made redundant. Many people who should be rewarded are suffering.
I have one more point on the local situation. I have tried to keep off the national situation, which other hon. Members understand better. Part of the reason for the present crisis is the Government's private finance initiative. It has been developed in such a way that short-term financial gains can be made, but only with long-term financial consequences. It is selling off the family silver.
For example, on 7 December last year, Nottingham health authority opened its refurbished headquarters, at a cost of £4 million. I think that it was opened by the


Chancellor of the Exchequer. I objected that I was not sure that that was a good way to spend money when other services were under threat. It is on Standard hill, an historic site in the centre of Nottingham. I did not know that the authority already had plans to sell it. I was amazed after the grand opening to find that out, not from the health authority but from a leak.
I asked the chairman of the health authority why the public did not know anything about it. He said, "You should know about it, because it is in the public domain." I then asked to see the discussions in the minutes of the multi-million pound deal to sell the headquarters building, the staff, fixtures and fittings, and then rent them back. But those matters had not been discussed. The massive deal did not appear anywhere on the health authority's public agenda, although it had been in process for more than a year.
The deal was only placed in the public domain through an advertisement in the Estates Gazette. My constituents do not spend their time browsing through that gazette to see whether the health authority is planning to sell buildings for £4 million or £5 million—the story is that it is to be sold for £4 million. If £4 million is spent on refurbishing something that is then sold for £4 million, it is being given away. The public in Nottingham have a right to object to that, but they cannot object, because they do not know about it.
I am amazed that, when the Government drafted new guidelines to ensure greater openness in the NHS, they said—in the annual report for 1994–95:
In its turn, accountability demands openness. Adding to existing codes of conduct and accountability, a new code of practice on openness for the NHS was published in April 1995. Its key principle is that information should be publicly available unless there is a good reason for confidentiality.
It continues to outline what people are expected to do under the code of practice.
When I was questioning the chairman of the health authority, he told me that lawyers had been brought in to see how little he could tell me. He said that he could tell me everything that was happening, as long as I made a vow of confidence and did not let the public know.
What is the Minister going to do to enforce his code of practice on openness and accountability? The chairman of the health authority has effectively told me that he is accountable to no one but the Secretary of State. I do not believe that; I believe that he is also accountable to the people of Nottingham—and to me.
Unless the people of Nottingham are told what is happening in relation to the private finance initiative, that accountability does not exist. The Government have turned the PFI on its head: and it has become the public finance initiative. The public sector chips in £4 million, which can then be passed over to a private company with no risk. When the Minister winds up, I hope that he will say what he plans to do about that.
It has become apparent in Nottingham that the trusts and the health authority try to operate no longer as services to the community, but as businesses. The board members are business people. I have no objection to trying to run things efficiently, effectively or cost-effectively, but the health authority and the trust need members who understand people's needs and not simply how to balance books.

Rev. William McCrea: The debate has been interesting—each hon. Member has naturally referred to his or her part of the United Kingdom. I have been left with the impression that Conservative Members are saying that everything is grand and good, while Opposition Members are saying that everything is bad and wrong. To be honest, I do not think that what either side is saying is strictly true: everything in the health service is not good, but nor is it bad.
I wholeheartedly agree with the comments of the hon. Member for Southwark and Bermondsey (Mr. Hughes), who said that we should speak about a common health service and its common ownership. As has been said, the NHS—and its record over the years—of which we in the House are rightly proud, is not the property of any one political party, but of the nation. We must therefore be careful not to overstate the case on either side of the argument. Right hon. and hon. Members should express their constituents' feelings and concerns about something that is near and dear to their heart.
The public rightly wants value for money. No one can excuse inefficiency in any public service—inefficiency is unacceptable. Cost-effectiveness is appropriate and proper, whether it be in the health service or any other community service. The people of Northern Ireland—a part of the United Kingdom—believe that the NHS is in crisis. Owing to lack of finances for capital and revenue costs, we face difficult times, especially as we approach the winter months.
I am not trying to make a party-political point. Amendment (b) states that the following words should be added to the motion:
and regrets that the official Opposition is proposing almost no extra funding for the NHS.
While I agree with much of the motion, which expresses many of the concerns that I hear from my constituents—it is right that those worries should be expressed on the Floor of the House—I do not believe that any credible political party can say that it condemns what another party is doing unless it says that it will make more funds available to the NHS. There have been White Papers, major documents, consultation documents and charter marks—all intended to improve the service—but there have to be follow-up finances.
There was a direct shift of policy in Northern Ireland designed to put care back into the community. I do not argue with that concept as I believe that people should be kept in the community for as long as possible. But although that policy has been introduced, arrangements and finances for the changeover have not been made available. The change from the use of institutions to placing people in the community—there was a dramatic change in the number of mental health beds in the Province and people were encouraged to go back into the community—cannot be made without appropriate preparation for such a move. Neither appropriate preparation nor sufficient finances were made available for that move.
We are proud of our NHS. I join other right hon. and hon. Members in congratulating those who work in it on their commitment—their service and high-quality care to the community is beyond reproach. But it would be wrong to suggest that there are no problems. My constituents tell me daily about their genuine problems and concerns at


what is happening: they see a change in the health service. Many of our elderly people feel concerned and forsaken. They believed that the health service would be there for them, whenever it was needed. When they were helping to build the service, as many of them did, they believed that they would be looked after in their old age.
I am greatly concerned that many doctors are anxious about the fact that, no sooner has a patient been in hospital for a few days, they are handed brochures for nursing homes to help them to choose to which one they should go. Homes are touting for business. I have no objection to nursing homes—they provide a service that the people need—but many of our elderly people are concerned about that. Many people who have worked all their lives and tried to save a few pounds for their old age are now finding that, when they are put into nursing homes, most of their savings are used up. Those concerns are widely felt in my constituency.
Many of the farms in my constituency are small, family farms that have been handed down for generations. The farmers do not consider that they own those farms, but that the farms have been lent to them for the period of time that they are on this earth, to be passed on to the next generation. Now, however, when many elderly people enter nursing homes, their farms have to be sold, which has caused a change in the make-up of the community. The elderly are right to express their concerns to us, as their elected representatives, and, as such, it is right that we express those concerns in the Chamber tonight to the Minister concerned.
The Minister with responsibility for health services in Northern Ireland, the hon. Member for North-East Cambridgeshire (Mr. Moss), sent out a document stating that there had to be a 3 per cent. cut for three consecutive years, starting this year. Half of that—1.5 per cent.—is demanded from cuts and savings in administration; but the other 1.5 per cent. will come directly from the service to the people.
To be fair to the Under-Secretary, I have to say that he is the first Minister who has come out and stated that to be a fact. Every other Minister would cover it up and say, "No, no, no. There are no real cuts—we are looking for those 3 per cent. cuts, but it will not affect the service." At least this Minister had the honesty to state openly that savings were being sought in the service. Although I am prepared to give him full credit for his honesty, it does not alleviate my concern about the effect of the cuts on the community.

Rev. Ian Paisley: My hon. Friend will be aware that there was an Adjournment debate today, in which was highlighted the case of a hospital that five successive Ministers for health promised would be built in the Causeway to serve the region of north Antrim and east Londonderry. That project is now in doubt and, although £10 million has already been spent on the scheme, it is now questionable whether it will ever be completed. Surely that should set the alarm bells ringing.

Rev. William McCrea: I thank my hon. Friend for his intervention—that case causes me great concern. I have been a member of several delegations and deputations to the Minister in respect of that hospital. The Minister promised us, with hand on heart, that the hospital would be built and that, therefore, the moneys that had already

been spent would not be lost. I should be greatly concerned to learn that it is now being suggested that all those Ministers' promises down the years have been nothing more than hot air and are meaningless.
There is an urgent need for a Causeway hospital in Coleraine to serve that wide area. A hospital was taken away from Ballymena, in the constituency of my hon. Friend the Member for North Antrim (Rev. Ian Paisley), and the people were promised that the area around Coleraine and Portrush would be served by a modern, up-to-date hospital. The Minister cannot get away with reneging on a promise that he has made and that successive Ministers have consistently made to the community.
Those year-on-year 3 per cent. cuts will eat into the very heart of health service provision to the community and we must not permit them to happen. Although the Government, perhaps with the forthcoming election in mind, have suggested that more money will be made available on the mainland—perhaps as much as £300 million will be released for the health service here—the truth is that no extra finance is coming to the Province. Therefore, the 1.5 per cent. direct cut in the service will certainly be felt by the community. We face the closure of homes for the elderly and cuts in the home-help service. That is a crying shame and the community is deeply concerned at the lack of resources.

Mr. Simon Hughes: I support the hon. Gentleman in the two points that he has made. First, as an English Member of Parliament, I say that it would be completely unfair if the additional money for the health service that has been announced by the Chancellor and by the Secretary of State for Health was not shared throughout the United Kingdom on an equal basis. Secondly, we cannot continue to have an arbitrary percentage cut in the budget year on year imposed simply in the name of efficiency, without any explanation or justification. The Government cannot set a target without explaining it. If the health service needs more money, it needs more money even if it also has to strive continually to be efficient.

Rev. William McCrea: I thank the hon. Gentleman for his intervention. First, it is sadly true that none of the tranche of money that has been announced will go to Northern Ireland. Secondly, as the Minister has openly stated, half of that 3 per cent. cut—1.5 per cent.—will directly hurt the service that is provided. I wholeheartedly accept the points that the hon. Gentleman made, both in that intervention and in his earlier speech.
The current system of trusts in the Province has created a level of administration that is unprecedented in any other part of the United Kingdom. In order to enable competition within the service, we have created many businesses—more than 20, serving 1.6 million people and all with their own chief executives, accountants and other administrative staff. We seem to be filling up the health service with an increasing number of senior administrators, who exert a great draw on the available resources, while at the same time the number of staff who actually deliver service to the patients is decreasing, to the detriment of patients in the Province. We need extra nursing staff and doctors in the health service.
I give the ambulance service in my constituency as an example. Two weeks ago, a newspaper reported that the ambulances going out on emergencies to people suffering


cardiac arrest are breaking down because they are years out of date. We can no longer be sure that ambulances will get to those who require urgent hospitalisation. The community is, rightly, concerned. I ask the Minister to encourage the Under-Secretary of State for Northern Ireland, who is now on the Front Bench, to provide the appropriate ambulances for my constituents so that they will get to hospital and receive the treatment they need.
Many other hon. Members want to speak, so I shall conclude. Although in the Province we appreciate the good things—and there are good things—in the health service, we believe that we are confronted with a crisis. We believe that the waiting times of patients requiring urgent hospital treatment and so on need to be attended to, and they cannot be attended to without adequate resources.
Whatever the governing party, no matter what is said about the national health service, unless the finances are made available we shall never be able to ensure that the national health service maintains the standing that we and our constituents have come to expect.
I shall listen with care to what other hon. Members, especially from Her Majesty's Opposition, say about their commitment to ensure adequate resources for the health service. For without adequate resources, all the rest will be hot air.

Mr. John Gunnell: I shall start by contrasting the image presented in the so-called White Paper, "The National Health Service: A Service with Ambitions", with the reality, especially as seen by a Member representing a Leeds constituency.
As its title suggests, the White Paper portrays the national health service as the Government would like it to be, not as it is. If the comprehensive health service in Leeds—the trusts, the health authority in its purchasing role and the Leeds Community and Mental Health Services Teaching NHS trust—were to receive £1 million for every time that the words "should", "could" or "needs to be" appear in that document, the health service in Leeds would be doing very well indeed. Sadly, the truth is rather different.
In their paper, the Government have postulated a health service in which their reforms are achieving what it is or was claimed that they would achieve. Perhaps if that were the case, the "ambitions" of the White Paper could be realised; but when examined in the real world, which is very different from the glossy aspirations, which reflect more hope than expectation, it becomes plain that the NHS reforms are not working, and that the proliferation of bureaucracy, which other hon. Members have spoken about, and the basic underfunding, which I want to speak about, have combined to the worst possible effect. That is evident in Leeds.
The Government themselves obviously believe that the NHS is underfunded. The uncosted promise made by the Prime Minister at this year's Tory party conference shows that they are at least conscious of the need for an increase in funding. But what are the public to make of an ambition to increase spending in real terms "year on year" which is conditional on what is described as a "growing economy" when the same Government are now telling the

British people that a series of Labour aspirations—no more than wishes—add up to £30 billion of spending commitments?
I am dismayed by the attitude of the Minister and the approach of the Government, and of the hon. Member for Southwark and Bermondsey (Mr. Hughes), who spoke for the Liberal Democrats, who expects commitments to be treated in the way in which the Express today talked about things that were desirable as resources allowed. Understandably, it is very difficult for members of the Labour party to offer spending commitments when their wishes are so misused by the Government in their propaganda and by other parties. We are embarked on a process in which electioneering of the lowest possible kind is becoming an everyday fact of life.
Given that process, and given this morning's publicity, I believe that the Prime Minister's vague NHS spending pledge should be regarded as having all the veracity of the White Paper's "ambitions".
I want to talk about the health services in Leeds. I believe that, by doing so, I shall shed light on the fictitious examples of best practice that the White Paper says should occur everywhere, revealing them as hollow. In the Leeds area, there are many skilled hospital and medical staff who share the Government's ambitions but strongly disagree with the chosen means of achieving them. I believe in being fair, so I shall mention some good aspects of the service in Leeds.
I have visited and spent time in the paediatric intensive care unit in the Leeds general infirmary, headed by Dr. Mark Darowski. It is an extremely good service, providing the best paediatric intensive care in the region. It is true that its skilled staff should, in the language of the White Paper, be able to meet the needs of the area, but that is a matter for the Government. They certainly did not do so last winter, and the changes that have come about or are coming about as we approach this winter will not enable them to meet those needs, despite the Secretary of State's promise in a statement to the House.
The community mental health day facility in Leeds has some longer-term beds, but it is run by the Leeds Community and Mental Health Services Teaching NHS trust. It was a great pleasure to open a facility in Middleton in my constituency. It must be able to meet fully the needs of the community that it is intended to serve, but the Leeds Community and Mental Health Services Teaching NHS trust, like the other parts of the Leeds service, is in deficit.
To surprise the Minister, let me pick out a welcome development. A GP fundholding practice in my constituency is building a day facility for people in Morley. It will not carry out large day surgery operations but it will do some things that will save people going to Leeds. In view of transport costs, I welcome that facility.
However, I very much hope that—as I am sure is the intention of those who are carrying out the development—the facility is available to all patients. If it were available only to people who happen to be patients of fundholding practices, it would emphasise the inequity in the system. I hope that, with the co-operation of the health authority and Her Majesty's Government, that facility can be made available for use by every general practitioner in Morley, as it would be under a local commissioning system that the Labour party would introduce.
I am not saying that good things are not happening; they are, but in each case there are flaws in the current system. The fundamental flaw is that, as the Secretary of State well knows, Leeds is grossly underfunded. Leeds general infirmary, the United Leeds Teaching Hospitals NHS trust, has a large deficit. I have been told that the trust's deficit is between £5 million and £11 million; I believe that it is nearer to £11 million.
The chief executive of the trust is one of the few chief executives with a salary of more than £100,000 a year. Running a facility like that, which the Government regard as a business, is obviously a highly responsible job, but the salary may be excessive, given the trust's deficit. I would expect the Minister to agree with me about that.
St. James's hospital, too, is suffering from a massive shortfall in funding and is in debt to the tune of between £2 million and £6 million. The Secretary of State knows the problems of Leeds very well because my fellow Labour Leeds Members of Parliament and I visited him some time ago to stress the difficulties being faced. We were encouraged to do so by the Leeds health authority, which also faces a considerable deficit and cannot purchase as it would want to.
In Leeds, all the bodies set up by the Government's reforms are in deficit, so the Leeds hospital service faces something of a crisis. When we spoke to him, the Secretary of State agreed to facilitate a meeting between the community health council—it also feels strongly about the shortage of funding—and the Minister. Representatives spoke to the Under-Secretary of State for Health, the hon. Member for Orpington (Mr. Horam). As a result of those discussions, however, no new money has been promised to Leeds. I am not talking about new money for the distant future; I am talking about money that is needed now, for this winter.
Leeds general infirmary was exercised—so were Ministers—about the two patients who were relatives and who both died on trolleys waiting for treatment at the infirmary. One of them had waited for eight hours before dying, the other had waited five hours. It is pure coincidence that they happened to be brother and sister. Leeds general infirmary soon realised that it needed more space for intensive care beds, but it can achieve that only at the expense of cutting 40 beds in the gynaecological unit. That work, too, is important.
My hon. Friend the Member for Nottingham, East (Mr. Heppell) drew attention to the fact that the number of bureaucrats has been increasing in the service every year while the number of beds in hospitals has declined. It is certainly a priority to increase the number of intensive care beds, but surely not at the expense of 40 other beds. The trust should not have to make that choice.
I wrote to the Secretary of State about the paediatric intensive care unit, which lacked the space for more than the five beds which it had been granted. It was then granted a sixth bed—which seems to represent an increase of one, but the space remains the same. Last winter, when there was a crisis, six beds were put into the same space. Now that the unit officially possesses six beds, perhaps a little more money will be forthcoming to staff it. It is a first-rate facility offering skilled treatment. That, after all, is why Nicholas Geldart was sent in the direction of Leeds. But a skilled facility needs enough space in which to operate. I therefore look forward to hearing that the intensive care unit will receive the funding for the extra beds that have been promised to the region: that is essential.
It is instructive to look at real cases, as opposed to the fictional cases offered us in the White Paper. When asked whether those cases were fictional, the Department of Health described them as composites of what they hoped future cases treated by the service would look like. I should like to describe some waiting list cases from the real world.
A woman of 93 suffered from a cataract, and her neighbour brought her to see me. She had to wait two years before even being seen, so between age 93 and 95 her vision would remain badly impaired. I am glad to say that because I wrote to the chief executive she was rapidly treated. It should not however be necessary for a woman of 93 to be put in touch with her Member of Parliament for action to be taken. A person who obviously needs treatment right away should be dealt with right away.
Another case that has come to my knowledge concerns a patient whose need to be seen was less urgent. When he came to see me, he had been told that he was on a waiting list of 108 weeks. I wrote to the chief executive of St. James's and Seacroft hospitals, who answered me as follows:
On a more general note, at present the orthopaedic service receives more referrals than we are currently able to deal with. This is not a new problem and we are working closely with our major purchaser, Leeds Health Authority, to reduce the waiting times for first appointment. We have 250 patients waiting to be seen for the first time in the orthopaedic out-patient department … The length of time these patients wait varies very considerably, often depending on their clinical need. Once these patients have been seen, if the decision is taken to place them on the in-patient waiting list, again the length of waiting time varies. We achieve the Patient's Charter standard of no waiting longer than 12 months".
So having waited two years and two months for his first appointment, my constituent faces another 12 months of waiting for treatment.
Before closing I want to mention the Leeds radiology service. I have written to the Secretary of State about the service run by the United Leeds Teaching Hospitals trust. I was referred to the chairman of the trust, to whom I suggested that people were not being treated on time. Referring to a recommendation from the Royal College of Radiologists, he said:
We acknowledge this recommendation … but due to inadequate capital resourcing our ability to start radiotherapy when clinician/clinically required is about four weeks longer than we would wish for some categories of breast patient.
It is not good enough to have to wait an extra four weeks—and all for lack of at least one new linear accelerator. We cannot wait for it to come; people are waiting longer than they should for the crucial first treatment that will enhance their survival chances.
It is, I contend, immoral to spend taxpayers' money on producing thousands of copies of a glossy, 60-page White Paper that presents an idealised account of what the health service could be with no concrete explanation of how to get there, in Leeds or anywhere else. The answer of course is more money. I also believe it wrong to involve civil servants in the preparation of a document that is totally bereft of practical policy. It is no more than a treading-water exercise, six months short of an election, conducted at great public expense to enhance the electoral


prospects of the Government—and the career prospects of some of its members. What the White Paper will not do, however, is benefit any member of the public who takes it, as intended, at face value.

Mr. Jerry Hayes: I apologise for not having been present for much of the debate, but I have been serving on a Standing Committee in which no pairing is allowed. Secondly, I declare an interest as an adviser to the Ivax Corporation and to the Western Provident Association, a non-profit-making body.
A few weeks ago my mother was seriously ill. She was immediately taken to the Royal Aberdeen infirmary where she was given the finest treatment imaginable. She is not exceptional: millions of other people are treated well by the national health service. We can all shroud-wave if we want to: we all know of constituency examples involving absurdities, bad management or the stupidity that one expects from any bureaucracy—but those are the exceptions, not the rule. The majority of people in Britain get a darned good service from the national health service.
I am fed up with being defensive about the health service. We should be proud of the achievements over the past few years: the fact that the health service is growing by 3 per cent. per year; the fact that productivity has increased by 40 per cent.; the fact that we are spending more money above inflation than ever before; the fact that, despite all the upheavals of the reforms that were necessary, we are treating 1 million more people than ever before and the waiting lists are at their lowest level since records began.
People would have laughed in our faces if, 10 years ago, we had given guarantees—in so far as guarantees are possible in any bureaucracy—that there would be treatment or an operation within a set period, as the patients charter requires. Yet it works—and, by and large, it works pretty well.
Earlier in the debate I challenged the hon. Member for Islington, South and Finsbury (Mr. Smith) about an article that appeared in The Independent entitled, "Is the NHS safe under Dr Blair's team?" The sub-heading states:
The Opposition's once distinctive stance on health has dissolved for lack of fresh thinking. Jack O'Sullivan examines a failure that the Tories will exploit in the next general election".
The article begins:
The NHS may be in poor shape, but its condition is nothing like as moribund as Labour's performance on health. After 17 years in opposition, the party no longer has a stance on the NHS that is either distinctive or convincingly deals with the problems that the service faces.
The Independent is not exactly a Conservative newspaper. The journalist refers to
Labour's complacent attitude, which has focused on scoring points in opposition rather than constructing a viable alternative.
That is precisely what we have heard today. I know that we are in that awful pork-barrel cycle in the run-up to a general election, but Labour's attitude seriously worries the elderly, the frail and the vulnerable. I hope that the Opposition realise how irresponsible their shroud-waving and scare stories are.
The article goes on to ask:
But what did Labour's opposition amount to? That the NHS needed more cash and that the Tories' changes would lead to privatisation".
We have heard all that.
The message rang true for voters. But it was a cynical tactic because, in reality, Labour offered little alternative to Tory policy, an inadequacy overlooked in the hysteria about funding shortfalls and the supposedly sinister hidden agenda of the Tories.
The article states that
the best that Chris Smith, Labour's new health spokesman, could offer at the party conference was an extra £40 million, gleaned from administrative savings, to cut cancer surgery waiting times.
The writer reports that a policy document, "New Agenda for Health", was published a few weeks ago by the left-leaning Institute for Public Policy Research, which states:
From where we stand now there will be no significant new public money for health care in the UK".
That is where Labour stands. I admire the courage of Opposition Members who use the forbidden word—the U word—underfunding. Why do they not tell us how they will match the money that the Government have given to the health service? Why do they not tell us their spending plans? It is not surprising that so many people—

Mr. Chris Smith: Will the hon. Gentleman tell us precisely what the Government's spending plans are for the next three years?

Mr. Hayes: It has been made clear what spending on the health service will be. My hon. Friend the Minister will go into great detail later.

Mr. Smith: Will the hon. Gentleman tell us some figures? The Government have not done so. No specific figure has been given for any of the next three years.

Mr. Hayes: In line with inflation—3 per cent. growth per year, year on year. That is the Government's promise: in line with inflation. They will deliver more money than the health service has ever had before—£42.5 billion.

Mr. Denis MacShane: I am fascinated by the vision of the health service getting richer and richer under the Conservatives. I do not ask the hon. Gentleman for further details relating to south Yorkshire, but Rotherham health authority has to cut last year's budget by £500,000 to £1 million. If all that new money is coming in, why are my constituents getting a worse service? Why is North-East Derbyshire health authority tell GPs that there can be no more elective surgery until the end of the financial year?

Mr. Hayes: I do not believe for one moment that any constituent is getting a worse service than before the reforms. I cannot give the exact figures to answer the hon. Gentleman's question because I am not an expert on Rotherham, but more cash has gone into his health authority and his national health service trust than ever before. It is up to the people who run those trusts to spend it in the right way.

Mr. MacShane: rose—

Mr. Hayes: The hon. Gentleman knows the amount of money that is being poured into the health service. He cannot deny it. He is an honourable, reasonable man. He


knows the reality. He is trying to score a few political points, for which I cannot blame him in the run-up to a general election.
The hon. Member for Islington, South and Finsbury wrote an article in response to the terrible accusations against his policy—I use the word loosely—by The Independent. He stated:
But we do want to make changes, because the introduction of the competitive internal market has caused immense damage. It has set hospital against hospital, doctor against doctor.
One might have thought that there would be a massive policy change, but there will still be the split between the provider and the purchaser. If that split still exists, can the hon. Gentleman tell the House that there will not be an internal market? Of course there will be an internal market. That is what has been producing the results and leading to greater efficiency and more patients being treated than ever before.
The article goes on:
Secondly, we envisage the development of a recuperation service, to help people recover from major treatment in a supported environment near to their home, rather than being forced out of hospital too early.
Have we had any figures for that? Is it an aspiration? Is it an aim? Is it costed? If so, will the hon. Gentleman tell us how much it will cost? I will give way to him, if he is listening. That is an important spending commitment. Is it a policy or just an election bribe with no price tag on it?
The article continues:
Fourthly, there is our proposal to use savings from excessive bureaucracy to fund, among other things, a reduction in waiting times for surgery for cancer.
The hon. Gentleman voted against the Government's plans to reduce bureaucracy. He and his party voted against the abolition of the regional health authorities. He wants to free £100 million from savings on bureaucracy. This year alone the Government have released £300 million, as my hon. Friend the Minister explained.
The article states:
Inequality of income and condition has a major impact on the quality of people's health, and inequality has widened dramatically over these past 17 years. We want to begin to put that right in government.
We all want to put that right in government, but it is a typical Labour aspiration of motherhood and apple soufflée. It is meaningless. The hon. Gentleman does not tell us how it will be done, or what money will be put into it, because he does not know. The iron shadow Chancellor will not tell him, because he does not know either.
What are these great policies—this great new Jerusalem—towards which the Opposition are leading us? The issue is not more money for the health service, although that is the issue on which they have fought election after election. It is the battle of the suits. They claim that Labour are better managers than the Tories.

Mr. MacShane: Yes.

Mr. Hayes: The hon. Gentleman says yes. He should go around some of the local authorities that are run by Labour. He should come to Harlow, where £1.8 million was lost out of a budget of £12 million and a load of people had to be sacked. That is the sort of management that there would be under Labour. Just look at local government.
The Labour party's proposals are delightfully vague. They tell us absolutely nothing.

Mr. MacShane: indicated dissent.

Mr. Hayes: The hon. Member for Rotherham sagely shakes his head, because he knows that the moment any spending plan is brought before the electorate and the House my right hon. and hon. Friends on the Treasury Bench will explain to the people where it is to come from.

Mr. MacShane: Will the hon. Gentleman endorse Labour's policy for a windfall tax to put a quarter of a million people back into work?

Mr. Hayes: Like so many other things, that does not work. The hon. Gentleman is talking about raiding pension funds, about raiding the consumer and about raising energy prices, which will affect the elderly, the frail and the vulnerable. That is what the hon. Gentleman wants to do, but it does not add up—like everything else that we have had from the embattled party on the Opposition Benches, which genuinely believes that it will win the next general election.
If ever an Opposition motion should have been strangled at birth, it is this one. I beg the House to oppose it.

Dr. Joe Hendron: Health has been defined by the World Health Organisation as a state of complete physical and mental well-being, not merely the absence of disease. The national health service was established in Northern Ireland in 1948, two years after it was established in Britain. Its purpose was to provide cradle-to-grave care for the entire community. That was nearly 50 years ago. Today there is a crisis in that great service, and there is a crisis in Northern Ireland.
I have listened carefully to the debate. Of course there are many good things with the national health service. Why would there not be? But that does not mean that there is not a crisis. I speak as a non-fundholding general practitioner who does very little GP work at this time. The main threat to health care provision is the across-the-board efficiency saving of 3 per cent. per annum which has been imposed by Government. It is, of course, Government policy to encourage people to take out private insurance.
In a recent article in the British Medical Journal, a group of senior medical consultants said that patients' lives were being placed at risk because of the pressure on trusts to make year-on-year efficiency savings of 3 per cent. The consultants said that cash cuts meant that patients were being sent home by hospitals much too soon after surgery. Indeed, in Northern Ireland there are many examples of patients being discharged with undue haste and with limited provision for follow-up care at home.
Although Northern Ireland receives 11 per cent. more per capita on health expenditure than the average for the United Kingdom, other statistics must be taken into consideration. Northern Ireland suffers 20 per cent. more heart deaths among men than the average in the United Kingdom. That indicates that for that component of the health service we would need an increase in resources of about 20 per cent. Northern Ireland's unemployment rate


is 40 per cent. higher than the rest of the United Kingdom. With unemployment comes increased visits to GPs, increased drug prescribing, increased referrals to out-patient departments and increased admissions to hospitals. Those were the words of the Chief Medical Officer for Northern Ireland in her recent report on the health of the people of Northern Ireland.
In addition to the increased number of heart deaths and the increased numbers in unemployment and poverty, it must be remembered that a quarter of a century of terrorist violence has brought with it increased health needs among our peoples, and that applies very much to both communities.
In recent weeks, the Prime Minister endowed the Secretary of State for Health—I hesitate to say this, as I have heard other hon. Members mention the figure of £300 million—with additional money for the health service. The Northern Ireland media gave the figure as £500 million. Perhaps that is inaccurate, but it is somewhere around that figure. I understand that not a penny piece of that will be directed to Northern Ireland. Indeed, it appears that it will go to England and Wales. If the first figure is correct, in terms of population it would mean £17.5 million for the health service in Northern Ireland.
In his statement of 12 February, the Health Minister for Northern Ireland, who was here earlier, said that cuts would not be implemented without reductions in service. I believe that that point was made by the hon. Member for Mid-Ulster (Rev. William McCrea). I congratulated the Minister at the time on his forthrightness in making that statement. I hope that he will guarantee that additional funding, in real terms, will be made available to deal with the implications of the Children Order. Will additional resources be made available to ensure that health boards can fulfil the commitment in terms of community care, which is required by the Government's legislation?
Has the Department of Health in Northern Ireland an accurate device to calculate the health needs and resources for health for the people of Northern Ireland in comparison to a base population, for example, that of England and Wales? How can the Minister be sure that resources that have been provided are adequate to meet the health needs of the population in Northern Ireland, bearing in mind the increased disease, poverty and unemployment? In its report published on 14 November, the Northern Ireland Audit Office recommended that any review of the capitation formula for funding should aim to ensure that the distribution of funds to purchase treatment matches the identified and prioritised needs of the purchasing authorities.
Why do we need more resources in Northern Ireland? It is the poorest region in the United Kingdom. I do not think that anyone would argue with that. In Northern Ireland, unemployment stands at 11.1 per cent.—39.8 per cent. higher than the United Kingdom average—and 38 per cent. of households live in poverty. Basic essentials cost more in Northern Ireland. For example, electricity prices are 3 per cent. higher. Although we spend 11 per cent. per capita more on the health service than the rest of the UK, our coronary heart disease level is 20 per cent. higher and unemployment is 40 per cent. higher. Long-term unemployment is linked with an increase in

the use of prescribed drugs, in consultations with GPs, in the use of hospital services and in the level of physical illness. Those figures come from the 1995 annual report of the Chief Medical Officer for Northern Ireland. All of that inevitably leads to increased demands on the health service in Northern Ireland.
What do the health cuts mean to the people of Northern Ireland? They mean that home help services are being cut, a reduction in meals on wheels, a reduction in key staff in the community such as social workers, community psychiatric nurses and day centre staff. I pay tribute to the people involved in primary health care, having been involved in it myself for 35 years in west Belfast. The cuts mean waiting lists for funding for domiciliary care packages and residential care. The hon. Member for Mid-Ulster referred to that earlier.
The Royal Victoria hospital Belfast has announced that it will not carry out non-emergency surgery on patients from non-fundholding GPs. The Ulster hospital carries out cancer procedures on patients of non-fundholding GPs free of charge, and I give it full marks for that. The Western health board in Northern Ireland has cut coronary artery bypass operations by 10 per cent. and there has been a 20 per cent. reduction in joint replacements and in ear nose and throat operations. If that is not a crisis, I do not understand the meaning of the word. There have been massive cuts at the Mater Infirmorum Hospital Health and Social Services trust. And so it goes on. I am aware that other hon. Members wish to speak, so I shall move on quickly.
On 30 October 1996, the Royal Victoria hospital, which is known world wide for its excellence—it was the first hospital in the world to have a cardiac ambulance—announced that because of funding difficulties faced by the Eastern health board it would have to stop non-urgent work across a wide range of specialties. The patients of GP fundholders would be all right—it was the patients of non-fundholding GPs who would suffer. I find it difficult to understand when Conservative Members seem to scoff at the fact that the patients of non-fundholding doctors have to wait. I could go on for hours about that subject alone. It is a crisis, but Conservative Members do not understand that. We are talking about thousands of patients and about primary health care.
Some people may try to blame non-fundholders and say that they should become fundholders, but I do not accept that argument. However, at present non-fundholding doctors have no choice but to apply to become fundholders. They must then wait nine months to a year to prove their accountancy abilities— although they were trained as doctors—before they are accepted.
The Government appear to have ring-fenced resources for the patients of fundholding GPs but have not done so for patients of non-fundholding doctors through the Eastern board. The Royal group of hospitals is the largest trust in Northern Ireland and has proportionately the lowest management costs in the Province. I opposed the introduction of trusts from the beginning, but I admit that in management terms the Royal group of hospitals seems to have performed its work fairly well in comparison with other establishments.
I appreciate that the Minister is currently considering an option appraisal for the Royal Maternity hospital, but I remind him that the hospital's neonatal unit serves the whole of Northern Ireland. It is a place excellence


where all major paediatric services are located, including paediatric cardiology, nephrology and urology. The main orthopaedic hospital in the north of Ireland is Musgrave Park hospital, which is part of the Green Park Healthcare trust. The Minister has asked the boards to channel cuts towards "non-life-threatening procedures"—I think that that is the correct term—which means reductions in elective surgery.
Hip joint replacement surgery will be cut dramatically from the record-breaking total of more than 2,000 joint replacements last year. Activity will probably be reduced by 50 per cent., which will mean an increase in waiting lists—waiting time is currently less than nine months—month after month. By the end of the financial year, patients may be waiting more than two years for joint replacement surgery. Further cuts will mean the dismantling of what has become the world's leading centre for joint replacement surgery.
The Minister is conducting a cost appraisal of the cancer services at Belvoir Park hospital, and it is important that the Green Park trust is represented on the team that carries out that appraisal. Industrial action has been taken at the Downe hospital in Downpatrick and at other hospitals throughout the north of Ireland. I should point out that the private organisation Compass is able to change the contracts of support workers involved in strike action: non-negotiated contract changes are totally unacceptable.
The Ulster, North Down and Ards hospital trust has also been severely affected by the cuts. Daisy Hill hospital in Newry—in the territory of my hon. Friend the Member for Newry and Armagh (Mr. Mallon)—serves all of South Down and Armagh, which is a remote rural area. The local population is implacably opposed to plans to centralise services at Craigavon area hospital. No direct public transport serves the hospital, so access is a major problem.
On what basis are decisions made to reduce the number of hospitals or to cut trust and hospital services? Are the reasons clinical, financial or professional? I should like to understand the basis of the decision making. Community trusts are also badly affected. The Eastern board has informed the North and West Belfast trust in my territory that "a phased programme of realignment"—what a lovely expression—is to be implemented. What does that mean? The board has simply used fancy words to say that services for the elderly will be greatly curtailed. The Down Lisburn trust has similar problems.
Community district nurses, community psychiatric nurses, social workers, health visitors and midwives are overworked and underpaid. They provide a magnificent service, but they are not appreciated by Government. Some such people are my patients and I have worked with others for years. They have told me their problems and I take no pleasure in recounting them today.
On 1 April this year, the British Medical Association produced a discussion paper entitled, "Financing the National Health Service". I accept Conservative Members' assertions that there must be some limits on the amount of money spent on the health service and that expenditure is based on taxation. I understand those points. The British Medical Association document: raises many issues, but the two central points are: first, the national health service is grossly under-funded and needs an immediate injection of funding; secondly, work must be done on methods of forecasting future demands and health care needs.
I believe in the fundamental principles of the national health service established 50 years ago. I believe that health care should be available to all, on the basis of need and not on the basis of ability to pay or whether one is the patient of a fundholding or a non-fundholding GP.

Mr. David Evans: We all know that the Labour party is quite capable of believing its own fairytales; its decision to debate the national health service shows its inability to tell the difference between fantasy and reality. To set the scene, we should take a trip down memory lane—after all, it is the only way in which we can measure Labour's achievements in government. The 1974 Labour party manifesto promised:
A Labour Government will expand the national health service".
Three years later, in 1977, Mr. David Ennals, Labour's Secretary of State for Health, was forced to concede:
In the present economic climate the Government could do little more than provide for the increasing number of old people, leaving a small margin for improvements in methods of treatment".
In 1977–78, the health budget was cut by 3 per cent. in real terms and capital spending was cut by a third in real terms—the biggest, most devastating cut ever inflicted on the national health service capital programme. Those who began the NHS, who gave birth to it, have battered it more than any Tory Government—eat your heart out, Aneurin Bevan. Between 1974 and 1979, nurses' pay fell by 3 per cent. in real terms, doctors' pay fell by 16 per cent., surgeons' pay fell by 25 per cent. and waiting lists increased by 48 per cent.
The economy as a whole reflects the state of the health service. Who will forget the 83 per cent. higher rate of tax, the 26.9 per cent. inflation rate or the Chancellor of the day turning around on his way to Heathrow and being told that the International Monetary Fund was running our economy? In 1978, Dr. James Cameron, the chairman of the British Medical Association, described how
The national health service is sick in Britain. It is inadequate and impersonal. It is losing the confidence of the medical profession and the public".
The 1978 Royal College of Nursing congress at Harrogate talked about
a crisis of manpower, finance and morale in the service".
The national health service went on strike in 1978–79, led by the Confederation of Health Service Employees and the National Union of Public Employees. Telephonists were on strike and clinical staff manned public telephone boxes to get calls into the hospitals. Clean linen was not allowed through picket lines and foul linen was destroyed because the unions would not allow it to be taken from the hospitals to be cleaned. Meals were provided by volunteers and cleaning was non-existent.
Let us cast our minds back to the news stories of the time, which do not reveal a health service nurtured by a caring, sharing Labour Government—quite the opposite. A 1978 article in The Times entitled, "Hospital is to turn away patients with cancer", stated:
Patients with breast, lung and other cancers, and abortion cases are to be turned away from the Kingston hospital, Surrey, because of industrial action by health service workers and supervisors. The hospital said yesterday, 'From midnight next Tuesday, even known cancer cases will be denied admission and lives immediately threatened. Investigative surgery, even where there is a strong suspicion of a life-threatening condition, will not take place'".


Even when we wanted to bury our loved ones—who might have died outside Kingston hospital—we could not do so, because the Transport and General Workers Union would not let the gravediggers dig the graves. We had to keep our loved ones in our living rooms until the gravediggers went back off strike.
In her confessions, the former Secretary of State for Health, Baroness Castle, described her attack on pay beds during the winter of discontent as an "essential political sweetener" for the trade unions. The Labour party is still committed to tossing political sweeteners to trade unions. In return, the unions toss financial sweeteners to the Labour party. We know that 176 Labour Members are sponsored by unions. As the TGWU boss said, "No say, no pay."
New Labour says that it intends to turn the clock back to the bad old days of the savage 1970s. As if that were not bad enough, it intends to strip health care professionals—administrators, doctors and GPs—of their power and put it in the hands of its new regional assemblies. What a recipe for disaster. Once again, the comrades will cut care. Their motto is, "Strikes first, patients last." Yet again the Labour party refuses to listen to the views of the professionals. Instead, it plays politics with the health service.
If Labour had its way, the national health service as we know it would be destroyed. Decision making would be stripped from health care professionals and given to pompous, political shop stewards, who would tear the service apart as a result of regional, industrial and political battles.
The lot opposite should turn the clock right back and try to understand Nye Bevan's intentions for the NHS. In 1946, he said:
I believe that democracy exists in the active participation in administration and policy. Therefore, I believe that it is a wise thing to give the doctors full participation in the administration of their own professions.
Given that statement, if Nye Bevan were still a Member of Parliament today, and he reflected on the Conservative reforms and Labour's plans, I am pretty certain that he would vote for the Government amendment at the end of the debate.
We have referred to the total disaster that was created last time Labour had power, and control of the health service and the lives of others. Let us consider what has happened since those dark days. It is an incredible story. Take GP fundholding. If all applications to join the scheme from April 1997 proceed, a further 3 million patients, and a total of 58 per cent. of the population, will be covered by GP fundholding. Since 1991, 15,000 general practitioners have joined the scheme, which is more than half of all GPs. In east Hertfordshire, which includes Welwyn Hatfield, fundholding covers 78 per cent. of the population, which is 20 per cent. more than the national average.
We are now spending on the national health service £80,000 every minute of the day. We are spending £724 a year for every man, woman and child. Total spending this year will be £42.6 billion. Spending on the national health service has increased in real terms in every year of Conservative government since 1979. The service treats 80 per cent. more acute patients than it did 17 years

ago. Nurses' average earnings have increased by 70 per cent. in real terms over that period. Capital spending has increased by 66 per cent. since 1979, which is in stark contrast to the 28 per cent. reduction under the previous Labour Government. Almost £2 billion was invested in NHS buildings in 1995–96 alone.
Now we come to the heart of the matter. The number of doctors in England increased from 56,000 in 1978–79 to 81,000 in 1995. The number of nurses and midwives has increased by 55,000 since 1979. Nurses' pay has increased from £68 a week in 1979 to £311 a week in 1995, which is an increase of 70 per cent. in real terms. The number of dentists has gone up from 11,919 in 1978 to 18,668 in 1996. Infant mortality per 1,000 live births has gone down from 13.2 to 6.1. Under Labour, it went down from 16.3 to 13.2. Even more impressive is the fact that over 3 million more treatments were carried out in 1995–96 than in 1979, and over 1 million more than in 1991. In all, 10.5 million treatments are carried out each year.
That lot over there have scored many own goals, and they have scored another one tonight. The NHS is safe in our hands. The elderly are safe in our hands. The sick are safe in our hands. The surgeons are safe in our hands. The nurses are safe in our hands. The doctors are safe in our hands. The dentists are safe in our hands. Our national health service has never been fitter, faster or more effective. The only people who would benefit from that lot over there being in power are the shop stewards and their trade union bosses. Labour would do what it always does: make a total mess of it. We owe it to the nation to ensure that Labour never gets the chance.

Mr. Brian Sedgemore: In the spirit of the age—which has clearly bypassed the hon. Member for Welwyn Hatfield (Mr. Evans)—I shall eschew ideology and party political point scoring and, instead, talk about health care in east London.
A few weeks ago, the Royal Hospitals NHS trust launched a £300 million private finance initiative scheme for a new hospital at Whitechapel, which is to be built and run by the preferred bidder, the Health Management Group. The press launch took place in a blaze of self-congratulatory publicity, but what was not revealed was the apprehension of clinicians, consultants and junior hospital doctors. Their apprehension was set out in a letter dated 9 October 1996 to Dr. Duncan Empey, the medical director of the Royal Hospitals trust. It was signed by David MacLean, the chairman of the Royal London hospital medical council, Larry Baker, the chairman of St. Bartholomew's medical council and Mr. P. Magee, the chairman of the London chest hospital medical council.
The letter refers to the £300 million scheme. It states:
We have heard from a large number of consultants, all of whom have been concerned that the space allocation in the new hospital for their relevant departments is smaller than they enjoy at present, and would certainly be inadequate for the planned patient flows. We were all originally promised that in the move to a single site the facilities would be equal to or better than those currently enjoyed, but this does not appear to obtain in plans from either consortium. This has caused a considerable degree of concern, and we feel that the future of the hospital as both an Accident and Emergency centre for the local population, and as a national and international centre of excellence, would be severely compromised under the available plans.
The letter continues: 


We are deeply concerned that if the issues of quality and quantity are not met, while in the short-term the Medical School and Hospital may appear to prosper, in the long-term recruitment will inevitably suffer and the quality of medical care, research and education will decline.
In my view, it takes a peculiarly incompetent Government and hospital trust to spend £300 million on a project and make things worse rather than better.
There is also considerable concern about the financial implications of the private finance initiative schemes that were referred to earlier, and particular concern about the financial end-loading of such schemes. It would seem that, in years to come, that could cause havoc to the revenue flows of the area health authority, and to the making of all its decisions. It might have to decide whether to support the PFI scheme down the years, or to stop spending money on hospital care in a variety of other local hospitals.
I am a member of the Treasury Committee. We have done some research into PFI end-loading, but I believe that more is needed. Let me make two suggestions. First, I hope that the National Audit Office will look into the matter. I know that John Bourne, who is in charge of the NAO, would like to issue guidelines on the potential dangers of the end-loading that will occur in future years. Although the NAO does not currently look into schemes that have not been completed, in order to issue guidelines it would have to do so, because there are not enough PFI schemes around. I hope that the Royal Hospitals NHS trust scheme, which is easily the biggest PFI scheme in the NHS, is be one of those that John Bourne will examine.
Secondly, the Health Committee should look at the revenue implications of PFI schemes and the dangers imposed on end-loading by the revenue flows. That must be examined in the context of the health management group in the scheme that I have mentioned asking for a rate of return no lower than 17 per cent.
As I have said, the Royal Hospitals NHS trust scheme is very big, and I feel that it is proceeding with undue haste. I believe that it is being driven by political imperatives rather than by serious medical considerations. The health management group might pause to consider that there could be a change of government early next year, and that the new Government might take a very different view of a PFI scheme that proposes, for example, to close St. Bartholomew's hospital. I see that one of its great alumni, the hon. Member for Wimbledon (Dr. Goodson-Wickes) is present; I hope that he will catch your eye, Mr. Deputy Speaker.
The health management group might like to consider that the children of my right hon. Friend the Member for Sedgefield (Mr. Blair), the leader of the Labour party, were born at St. Bartholomew's. It might also like to consider that the constituents of the next Secretary of State for Health, my hon. Friend the Member for Islington, South and Finsbury (Mr. Smith)—who is also present—actually use the hospital. Not only are there powerful logical, financial and medical reasons for the health management group to go a bit easy, unless it wants to wreck its own scheme and its own financial future; there are powerful emotional forces backing the retention of St. Bartholomew's as part of any PFI that eventually sees the light of day.
Another point, which relates partly to the PFI scheme, concerns the future of paediatric care in east London. We have been told that there is no crisis, but there is certainly

a crisis in east London's paediatric care. Part of that crisis is set out in a document marked "Strictly Private and Confidential" which comes from Vanessa Wright, clinical director of children's services at the Royal Hospitals NHS trust. It is dated 4 September 1996. It begins:
The financial position of the Children's Services Directorate at 31 July 1996 … shows a worsening overspend of …660,418, with a predicted year end out-turn of £1.366 million overspent … Senior management in The Royal Hospitals NHS Trust have made it abundantly clear that radical action has to be taken now to address this situation.
The overspend has knock-on effects on paediatric care at both St. Bartholomew's hospital and Queen Elizabeth hospital for children. Everyone knows that St. Bartholomew's has a world-renowned paediatric cancer service. Following the scare document produced by the Royal Hospitals NHS trust, two proposals have been made so far. The document itself suggests shutting that world-famous paediatric cancer service—which would cause a public outcry—and transferring it to Queen Elizabeth hospital for children by 31 March next year. I do not believe that that will happen; I think that there will be second thoughts.
Professor Lilleyman, however, has made an even more bizarre proposal. The professor, who has a privately financed chair at St. Bartholomew's, has proposed taking the whole unit—its facilities and patients—to Guy's hospital, south of the river. He made that proposal without the consent of the hospital for which he works. May I ask the Minister whether it is lawful for a professor with a privately financed chair to take an entire unit and its patients to another hospital without the permission of the Royal Hospitals NHS trust? I understand that Guy's is quite prepared to pinch that world-famous unit for reasons of prestige.
Even the Royal Hospitals NHS trust does not like the idea. I have spoken to its chief executive, Gerry Green, who has made it clear that if Professor Lilleyman does try to scoot off down the river with the unit, he will go without facilities, without money and, in fact, without his clothes. I understand that he has said that the professor will go in his underpants and nothing else.
It is the legality aspect that I find bizarre, as, I am sure, will every Member of Parliament. I want to ask the Minister about the future of paediatric care, without scoring any political points and without attacking the trust. I hope that he will give us a guarantee that if the Queen Elizabeth hospital, whose closure was announced three years ago, does close within the next year or so—it was originally intended to continue into the year 2000— alternative facilities will be made available before it shuts. If it does, three things will be needed.
First, the new Homerton hospital has no paediatric beds at present, although it has just appointed an ambulatory paediatric consultant. If QEH shut, 25 or 30 children's beds would be needed at Homerton, probably by next autumn. Secondly, two wards would probably have to be moved from QEH to St. Bartholomew's to complement the existing two wards. Thirdly, the shortfall in beds that would still exist would have to be made up by the provision of more children's beds at the Royal London hospital.
I have spoken to the Royal London hospital, to the chairman and chief executive of Homerton hospital and to consultants at St. Bartholomew's. I hope that the Minister can give us an assurance that, should QEH have


to close rather than stay open until 2000, the new beds will be provided at Homerton, the two new wards will be opened at St. Bartholomew's and the extra beds will be made up by more children's beds at the Royal London. Queen Elizabeth hospital is much loved, but it does not have state-of-the-art facilities. Its theatres and its diagnostic back-up are not state of the art. Unless rebuilt on its present site, it will probably be impossible to keep it open. If the Minister can give me that assurance, some use will have come out of the debate.

Dr. Charles Goodson-Wickes: Until the hon. Member for Hackney, South and Shoreditch (Mr. Sedgemore) enlightened me, I did not think that I had much in common with the Leader of the Opposition. I now find that both he and I had children born at St. Bartholomew's hospital, which proves two things. We both know a good hospital when we see one and we both believe in the national health service because, for those Members who are not aware of the fact, St. Bartholomew's has never had any private beds. I was trained and I worked in the hospital as a clinician, and I am proud of its record and all that it stands for.
The Government's reforms, particularly those since 1991, have been a great success and are a cause for rightful celebration after 50 years of the NHS. I never believed that, in my professional life, the health service could claim to be world class and decentralised, with emphasis on primary care teams. For proof of the success, one need look no further than the Opposition's typical hypocrisy on all the reforms over which they have fought so vigorously. Will they abolish NHS trusts? Of course not. Will they abolish general practitioner fundholding? Of course not.
I read the words of the hon. Member for Islington, South and Finsbury (Mr. Smith), soothing members of the British Medical Association—again I declare an interest—and telling us all that he is not a revolutionary. If he is ever lucky enough to hold office, he may tinker around the edges, but I suspect that the whole thing is an absolute farce and that he and his party will, in effect, continue the reforms that the Government have ably put in place.
The ultimate test is always whether patients have benefited. The answer, of course, is that they have. The figures are absolutely irrefutable. Since the reforms, patient treatments—I think that they are called episodes in modern parlance—have increased vastly, by around 1 million. Waiting lists have been reduced to their lowest level ever. All that has been achieved in the context of the oft-derided patients charter.
During the summer recess, I found myself on the receiving end in Odstock hospital, in the constituency of my hon. Friend the Member for Salisbury (Mr. Key). I cannot speak highly enough of the treatment that I received. There was none of the hanging around that I remember so well as a medical student, clinician and patient. My condition was hardly life threatening, but I was whisked from accident and emergency into theatre within an hour. On the ward, I saw nurse teamwork, which I had not always seen in the past, and excellent liaison between nurse teams as they came on and off duty. 
When I was discharged from hospital—I am sure every hon. Member knows that I and my family have always been NHS patients—I was admirably looked after by my local GP fundholding practice, by its district nurse and by the community pharmacist. That was an index of what the reforms have achieved: efficiency in a caring atmosphere.
In my constituency, no less than 79 per cent. of patients are covered by GP fundholding practices. The borough of Merton, in which my constituency lies, is arguably the best served in London by NHS trust hospitals. Perhaps the service is equivalent to anything in any conurbation in the world, even though none of the four hospitals is actually situated in the borough. My hon. Friend the Minister and his colleagues, however, will be aware of recent consternation in south-west London. Merton, Sutton and Wandsworth health authority, recognised by the Under—Secretary of State for Health, my hon. Friend the Member for Orpington (Mr. Horam), as not a profligate one, reported a financial crisis in the offing. Its proposals to counteract the potential crisis were alarming.
For instance, there was talk of non-urgent elective surgery being savagely reduced—not stopped, as the Labour Front-Bench spokesman said earlier. Inevitably, that would mean the return of longer waiting lists, which not only goes profoundly against everything that the Government have achieved, but is clearly unacceptable to patients and their families, and puts an extra financial burden on the social security budget. That litany of events has therefore caused much concern in my constituency and in the constituencies of many of my hon. Friends and of Opposition Members.
My right hon. Friend the Secretary of State for Health was generous with his time in listening to our concerns. I trust that that generosity will be matched by my right hon. Friend the Chief Secretary when he responds—as I speak, he probably has responded. I hope that my constituents' understandable alarm will not be prolonged beyond next week's Budget statement, after which, clearly, rapid executive decisions will have to be made as to how funds are applied.
I recognise that, in winding up the debate, my hon. Friend the Minister cannot give assurances, but I emphasise the number of meetings that we have had on an all-party basis. We have had meetings with representatives from St. George's hospital, St. Helier hospital, Kingston hospital, Queen Mary's hospital, Roehampton, and Merton, Sutton and Wandsworth health authority, its chairman and its chief executive. They have already—I congratulate them on this—found efficiency gains of some £5 million, but further savings that have been asked for of £9 million are, I believe, impractical. They have a genuine case. I hope that my right hon. Friend the Secretary of State for Health has been able to pass on our concerns to his Treasury colleagues.
After that acute problem has been solved—I am confident that it will be—it would be prudent for my hon. Friends to revisit the issue of the calculation of the capitation formula for resource allocation. We all know that such formulae are beset with difficulties. In Merton, we have had awful problems with the standard spending assessment. That has affected, for instance, teachers' pay because Merton is neither a truly inner nor a truly outer London borough. All hon. Members know how complex


those calculations are, but we should revisit the matter in relation to our local health authority.
From the point of view of my constituents, I can never contemplate surrendering the potentially bright future of Nelson hospital, which is bang in the middle both of my constituency and of the borough, and for which many of us have fought so hard and so long to ensure that it has a vigorous future in Merton. It absolutely epitomises the return of the cottage hospital. We have heard talk of cottage hospitals being closed. I am delighted to tell the House that I have received assurances from the St. Helier NHS trust that, despite its financial difficulties, it believes that plans for Nelson hospital can go ahead. That will be cause for much celebration in my constituency.
Even Nelson hospital, with its proud record as a hospital in Merton, will give due deference to St. Bartholomew's hospital, for which the hon. Member for Hackney, South and Shoreditch has been such a doughty fighter. For too long, I have had to live with a sense of terrible guilt about what was done to the hospital. I believe that an academic and medical act of vandalism has been carried out on that hospital, after its nearly nine centuries of being in the forefront of delivering medical care, often to the most needy people in a part of London that was never particularly privileged.
During the consultation period, in February 1995, I expressed in writing to East London and The City health authority my gut feeling that the new buildings at the Royal London hospital might never appear, or not appear to the extent that was predicted. I very much hope that I am wrong, but I suspect that my worst fears will prove to be true because of financial demands or for other very practical reasons.
I profoundly regret that I was persuaded to vote in favour of the reconstruction and the effective movement on to one site of Bart's and the Royal London hospitals. In the context of party unity, I suppose that we must all trim occasionally. I am certainly ashamed, however, that I rationalised my vote on the basis that there was never an undertaking from the Opposition that they would reverse the decision.
I am even more aggrieved that one of the arguments made about closing Bart's, to reassure me and those of my hon. Friends who had doubts about it, centred on the issue of accident and emergency facilities for the City of London. I remember being reassured by former occupants of my right hon. Friend the Secretary of State's office that I need have no worries, because there would be adequate cover from the accident and emergency unit at Guy's hospital. We all know what has happened since then. It seems inevitable that the accident and emergency department at Guy's will be closed and shifted to St. Thomas's hospital. Therefore, the entire argument proved to be entirely bogus. One day, I suspect that the House and those who made the decision will come to regret it.
Now there is at least some light on the horizon. I do not expect that I shall be able to make entirely common cause with the hon. Member for Hackney, South and Shoreditch, but, in the past, I have criticised the City of London for being less than vigorous in its defence of St. Bartholomew's hospital. It is quite extraordinary that a body of that strength and antiquity should appear to be so inhibited in protecting such a unique—I use the word in its proper sense—hospital. Now we may be able to

retrieve something positive from a disastrous situation: the Royal Hospital of St. Bartholomew Charitable Foundation. The fact that that charitable foundation has been allowed to use the word royal is significant. Its members are working with the special trustees of St. Bartholomew's hospital and the Corporation of London, forming a tripartite body of absolutely impeccable credentials.
While a decision is awaited on the private finance initiative application, which the hon. Member for Hackney, South and Shoreditch mentioned, the waters continue to be muddy. I do not pretend to the House that I can predict the outcome. Perhaps we shall end up with a dual-site option, with some specialist units continuing at Bart's, or perhaps there will be a completely new and exciting opportunity for an innovative model on the Bart's site, where the public-private interface will work. It has even been suggested that there might be a private provider that will provide a community centre or even contract back into the NHS. That type of synergy sounds like a very exciting possibility. An accident and emergency department could even be reintroduced with private funding.
Those proposals could be a blueprint for the future. I do not say that any of them are in a final stage of formulation, but I beg my hon. Friend the Minister to assure the House that, whatever happens to the Bart's site in the future, he will properly involve the Royal Hospital of St. Bartholomew Charitable Foundation, the aims of which are
To establish on the Bans site an Independent Charitable Hospital and a Medical School of International standing",
so that the fine traditions of that hospital can continue in a manner that is best suited to the century ahead.
None of us can predict with any certainty how the NHS will develop and what administrative, financial and political factors may guide it. In the future, I believe that there may even be fewer tiers. The Government have done admirable work in reducing tiers in the NHS, and there may be further radical moves that they could make. An NHS executive, for example, could deal directly with NHS trust hospitals, which might provide greater flexibility and responsiveness, always with the patients' needs at the forefront.
One matter about which I am absolutely certain is that the Labour party will always prove to be the old guard, dragging its feet until it sees that the reforms make sense. Labour Members cannot bring themselves to admit that the changes make sense and congratulate the Government on what they have achieved. That is the pattern of what has happened over the past 17 or 18 years.
Today we heard about new Labour's expenditure plans, which will certainly entail more costs, although no more patients being treated. Whether one is talking about abolishing the internal market, withdrawing the PFI, reintroducing regional health structures or ending compulsory competitive tendering, the battles have been fought and won by the Government, and the Opposition's proposals will simply ensure that money and effort will be diverted from patients. In stark contrast, no one can challenge the effectiveness, innovation and courage of the Government's initiatives.
I hope that between now and the general election, whenever it comes, the opportunity will present itself not only to continue those excellent policies, but to publicise their benefits rather more vigorously to patients and to the country.

Rev. Martin Smyth: The hon. Member for Wimbledon (Dr. Goodson-Wickes) gave a balanced speech and, while pointing out the positive aspects, expressed his concerns about what has happened with some of the reforms. I should like to share the positive note that he struck, because too often we minimise the excellent work that has been done in the national health service over the years. I am familiar with the NHS through my personal experience and as a pastor and because my family has used it, and I understand not only the good work that it has done but the changes that it has undergone. Having said that, however, I think that the Government occasionally overstress the positive side of the NHS and fail to realise that there may be problems with it.
Some years back, when he was a Health Minister, the right hon. Member for Peterborough (Dr. Mawhinney) was answering in a very positive manner for the Government during Question Time, and I was called by Madam Speaker to ask my supplementary question. I asked, "Will the Minister accept that we are not in heaven yet?" There was a sedentary intervention from a Conservative Member, who cried out, "That's what we're trying to prevent." I understood what he meant, but the fact is that there are problems in the health service, and we should at least be dealing with them.
Earlier in the debate, it was said that, in the past, hospitals and health authorities were always able to balance their books. I wonder whether the problem today is that we have a different type of accountant, or that medical politics are being played. We are consistently told that we cannot provide services because we are already in the red. If it was possible to balance the books in the past when there were shortages in the health service, why can that not be done now? At no time have any Government been able to provide the finance to cover all the health service's demands.
Another difficulty through the years has been with changing medical practices. Some practices were held on to for too long because people were accustomed to the work, happy in their environment and not prepared to move on. At times, developments were retarded.
Rather interesting comments have been made about cutting administration costs, for which there is a place in some areas. Dr. Sandy Macara of the British Medical Association said not so very long ago that the question was not whether there should be less management; the service was happy with it. What it needed, he said, was more money. When we constantly criticise the amount spent on administration, we should bear in mind such a salutary warning, which was repeated by a recent witness to the Select Committee on Health, who claimed that more and better management was necessary to improve and co-ordinate children's health services.
On the other hand, we must fire a shot across the bows of some managers, for I am not convinced that some of them are managing well. When one bears it in mind that some of them are getting more money for a year's work than the Prime Minister of the nation, it seems that we should demand a better service from them. In previous debates both in the Province and in the House, I have asked whether it is right to give bonuses to managers for cutting down on lower-paid workers, which seems to have been happening for some time. I have very little sympathy

with trusts anywhere, especially in Northern Ireland, when they make ancillary workers redundant to save money, yet increase managers' salaries. I shall illustrate that point with regard to one of the finest hospitals in the United Kingdom.
I have a letter from a person in North Down, a copy of which he sent to the hospital's chief executive. It said:
I visited a friend who is a patient in ward 17 … and found that she and others on the ward were on beds that did not have sheets, pillowcases or indeed any proper bed covers. When I enquired why this was so my friend advised that the laundry had not been received, this was at 4.00 pm!!
I find this totally appalling and unacceptable. I realise that it has been necessary to implement cuts in the health service but surely the people who are ill deserve to receive humane treatment. and that includes clean bedding.
I had had experience of such a problem earlier when I raised a similar issue with the management.
I share the concerns of the hon. Member for Belfast, West (Dr. Hendron), who referred to the letter that the medical director of the trust wrote to general practitioners in October, which said:
elective activity for patients of non fund holding medical practices "—
within the board area—
will be ceasing".
I am not convinced that the question is simply one of giving preferential treatment to GP fundholders, for I am reminded constantly that emergency work and other types of serious surgery are still paid for—even that of GP fundholders—by the boards and regional authorities.
There is an experiment in total fundholding at the moment. Given last year's experiences, it seems that there is a tendency to go ahead with spending the money that is available from GP fundholding, in the knowledge that at the year end the boards will be able to provide extra money because they have saved it. Have the Government rightly been blamed for gross underfunding, when no one—from my party, other Opposition parties, the BMA or anybody else—has said what amount is needed adequately to provide what is demanded of the NHS? Those who constantly criticise the health service will have to address that issue realistically.
At the same time, I am not prepared to accept the explanations of the Department and of others in Northern Ireland who blame the shortage in health care and other areas on what they call the "disturbances" of the summer. As I understand it, all the budgets were set before the summer. Unless the Minister and the Department employed the services of Mystic Meg, I do not know how they foresaw that perceived disturbances in the summer would have an impact on the budget. I refute such an allegation, especially bearing in mind the fact that the Consolidated Fund does not include security matters. Indeed, we are regularly told in appropriation debates that we should not be referring to the security budget. The 3 per cent. cut was changed to 1.5 per cent. when the Minister realised that such a cut could not be made.
Concerns are being raised—I have heard the Minister and others speak of them—that capital investment might be cut to feed current expenditure. That would be deplorable and short-sighted, bearing in mind the fact that it has been pointed out in the debate that, under a former Administration, there was no funding of capital building for years. It takes a long time to catch up on such capital


expenditure. It therefore seems that such cuts would ultimately add to unnecessary expense in the long run. I am convinced, however, that there is still a case to be made for efficiency savings, while at the same time providing the extra funding that is needed to meet the shortfall because medical, surgical and other establishments are developing new forms of treatment. They are expensive, but in the long run they will add to the quality of life for patients and for the rest of the people.
Having spoken of the large improvement in the health of our nation and praised ourselves for it, we should ask: why is there suddenly a spate of emergency admissions? Is it as a result of self-interest, as people try to add to demands on their budgets, in order to demand more money from the Treasury for their particular speciality or trust? We are all competing in the same field.

Mr. Matthew Banks: It is a great pleasure to catch your eye, Mr. Deputy Speaker, in this important health service debate. Hon. Members on both sides of the House know only too well that sometimes, as a result of commitments in this place to Standing Committees, and so on, it is not always possible to be present for all the debate. I sincerely apologise to the Opposition Front-Bench spokesman, and to my right hon. Friend the Secretary of State for Health for—unusually for me—not being able to be here as a result of service in a Committee earlier this afternoon.
The debate has been interesting. As I look across the Chamber and along the Conservative Benches—although to a place perhaps a little detached—it is pleasing to see that we not have not only Members who represent English constituencies but our friends from Northern Ireland. Northern Ireland is very much an integral part of the United Kingdom, and it is entirely right that Northern Ireland Members should contribute to the debate. I regret that, in the unlikely event of there ever being a Labour Government, devolution plans will carve up the country, and who knows what will transpire.
In an interesting and forthright speech, which we have come to expect from him, my hon. Friend the Member for Welwyn Hatfield (Mr. Evans) read out what to me was an appalling record, and an indictment, of the last Labour Government.
My constituency should have had its brand new hospital in the 1970s. The references made by my hon. Friend the Member for Welwyn Hatfield to the Chancellor rushing to the airport and then having to come back to London and the crisis surrounding this country having to go cap in hand to the International Monetary Fund struck a chord with me, because the new hospital in which I have been a patient and which many of my constituents use, should have been built in the 1970s but was not, because the capital building programme was cut by one third by the Labour Government. My constituents had to wait for the election of a Conservative Government before progress could be made.
In the same vein as other hon. Members, I should like to refer to some of my personal experiences of the national health service and make a couple of points on national issues, as well as referring to one particularly important local issue for Southport. I know that one or two other hon. Members wish to speak, so I shall be brief.
I do not propose to repeat most of the points raised by my hon. Friend the Member for Welwyn Hatfield in his early remarks. However, when I receive a critical letter

from a constituent about the health service, I shall send them a copy of his speech, which sets out only too well the record of the 1970s. As my hon. Friend said, there is no better way to see what may happen in future than looking at how people have acted in office in the past.
I have been fortunate in having been in hospital on only a couple of occasions. Touch wood, I have had good health, apart from when my career in the Gordon Highlanders was cut short and I had to be invalided out; and, more recently, during the Maastricht debates. I do not know whether it was because we seemed to be going through the night rather a lot, but I remember turning up for what I thought would be a routine meeting of about 30 minutes with the chairman of my local NHS trust in 1993, and coming out of intensive care seven days later.
I pay tribute to the professionalism and care of all the staff and administrators at the Southport and Formby Community Services trust. I am sure that the quality of health care provided to my constituents by one of the country's flagship trusts is reflected in other parts of the country. What my hon. Friends have already said proves that.
The difficulties in and around my constituency are, in some ways, the difficulties of success. As a result of the Government's policies and the year-on-year real-terms increases in health service spending, we have a couple of pretty new hospitals five miles apart. Over the past few months, two local health authorities—South Lancashire and Sefton—have conducted a public consultation exercise on their plans to put particular specialist services in one hospital or the other. The advice of the clinicians—not the bureaucrats—has been that, to maintain important services such as cancer services, there must be centres of excellence throughout the region, never mind throughout the country.
With two new hospitals not far apart, tough decisions sometimes have to be made. One difficulty of having two health authorities is that sometimes, for the wrong reasons, bureaucracy can take over. The provision for my constituents and those of the hon. Member for West Lancashir (Mr. Pickthall), who, unfortunately, cannot be here for this debate because of important engagements elsewhere, has been the subject of a review, because the two authorities have not been able to agree on what to do. Because they could not decide which services should be concentrated on one site, they decided to commission Sir Duncan Nichol, the former chief executive of the national health service, to undertake a report. He decided that there should be a hot site and a cold site. He then decided that the hot site should be in Southport, and the cold site in Ormskirk.
Unfortunately, in spite of having commissioned the report, the two health authorities were still not able to agree on implementing its recommendations. I understand perhaps more than most the sensitivities of the issue, but, as others have pointed out, it was as a sop to those in the Ormskirk area that the two authorities decided that, although all the services would go to Southport, a new maternity unit would be based in Ormskirk.
That process has got no further, because a petition was put together with more than 20,000 signatories. It was concocted by several local people with a passionate and genuine interest in the continued provision of local maternity services in Southport. They did not want those services to go five miles down the road to Ormskirk.
Unfortunately, as so often happens, one or two local politicians jumped on the bandwagon of what had, until then, been a non-political public debate. One in particular, a local councillor by the name of Ronnie Fearn, who is known to hon. Members, decided to take hold of the petition, saying that it would be safe in his hands, and he would present it to the health authority. So safe was it in his hands and so competent was he that he presented it to the wrong people. They had to put it in a brown envelope, put some stamps on it and send it to the health authority that was conducting the review.
The point of that story is that neither of the community health councils, made up of local people, has been prepared to object to the health authority's proposals. We have a problem if local people on the community health council are not prepared to oppose plans that concern so many people in my constituency.
As I have made clear once before, I believe that the way to make progress on this constituency difficulty is to try to bring all the health services in Southport on to one site. The way forward is certainly through the private finance initiative. I am pleased that the Southport and Formby Community Services trust is undertaking pioneering work in that respect on new buildings.
There is one further piece in the jigsaw that I should like to see in future. I hope that my hon. Friend the Minister will listen to my plea for him to consider closely the arguments that I am putting now, and shall put again in writing, for a special capital allocation, perhaps through the regional health authority, to ensure that the services at Southport general infirmary, which is now very old, can be moved to the new hospital site at Kew. I hope that my hon. Friend will be able to give me a positive response to that request at the end of the debate.
As other hon. Members wish to catch your eye, Mr. Deputy Speaker, I will conclude simply by saying this: the record of the last Labour Government was such that we cannot trust the health service in Labour hands in the next Parliament. My constituents should have had their new hospital in the 1970s. We did not have it, because the Government of the day had to go cap in hand to the International Monetary Fund after they had bankrupted us. We had to wait for the election of a Conservative Government, and I have no doubt that, as far as local health services are concerned, the best interests of my constituents are served by the re-election of this Conservative Government.

Mrs. Audrey Wise: We have heard a pretty remarkable display of complacency from Conservative Members, who have suggested that any criticism of the national health service is a slur on the service, or even shroud waving. Conservative Members seem to think that Labour Members are the only people who are worried about the current situation in the NHS. If that were so, it would not really matter, but it is not. Conservative Members should listen more to their constituents and to the staff who work in the service.
Much praise has been directed towards the staff from both sides of the House and I certainly want to add my voice to that. I admire the devotion of most people who work in the NHS, who are expressing their worries in no

uncertain terms. Their devotion is often taken advantage of. I worry about their work load, and they are often underpaid. At the moment, they have to waste time, effort and money in local negotiations, causing a completely wasteful duplication of effort, whose only purpose is to play one area and one worker off against another. That is nothing to be proud of, and it is certainly not efficient.
People who work in the NHS do not complain only, or even mainly, about their pay. I think that all hon. Members will have received the briefing from the Royal College of Nursing, which states:
The RCN has conducted two surveys of accident and emergency units in 1994 and 1996. Last winter our survey results showed that nearly half the A and E units monitored still had patients waiting overnight on trolleys.
The RCN is not casting a slur on the NHS. Its members work in the NHS, and I believe that they are proud of it. They are not proud when patients have to spend many hours on trolleys.
The management of the Preston Acute Hospitals NHS trust were not casting a slur on the national health service when they recently expressed to me their great worry and unease that the private finance initiative, at least as it is presently constituted, would remove from them the control that they should have over future hospital development. Theirs was a thoughtful appraisal of something that will have a long-term effect; it was not casting slurs or shroud waving. We ignore such expressions of concern at our peril.
Of course, Conservative Members are too busy filling the airwaves with claims that more and more people are being treated. All sorts of somewhat spurious statistics are put before us. In the figures used by the Government Front-Bench team, it is not patients who are measured, but finished consultant episodes. Those are not necessarily the same as people. The Government should spend more time and effort trying to collect meaningful statistics— for example, for the league tables that rate hospitals one against another, which are important, as they can greatly affect which hospitals attract contracts. Often it is not the most vital things that are measured.
Why not do as the RCN suggests, and collect information about the incidence of hospital-acquired infections? That would be a measure of hospital efficiency, and it would be a great deal more meaningful.
Day care is another item that has to be considered. We are all in favour of day surgery units for appropriate use. I recently had the pleasure of opening a day surgery unit at the Royal Preston hospital. As a member of the Select Committee on Health, I have questioned Ministers about how they define day surgery units, and have discovered that they count only those that send people home in the evening; so, if a hospital prefers to have a unit that provides overnight recovery beds, it is not counted as a day surgery unit, yet that unit can use its facilities far more efficiently, because the whole day is available equally for operations and procedures.
In other units, less recovery time is available as the day wears on, so only more minimal procedures can be carried out in the afternoon; yet a hospital that considers that and decides to have overnight beds will not be counted as providing day surgery, and will suffer in the league tables and when purchasers consider awarding contracts.
In the national health service, we have to consider equity according to age and equity according to geography, among other issues. The national health


service is not truly national and equitable across geographical areas. I shall give an example that works in favour of my area in the north-west. Far more multiple sclerosis patients in the north-west than in any other area are treated with a new drug, which can be extremely useful in certain circumstances but which is undeniably expensive. I do not believe for a moment that that is because the profile of multiple sclerosis sufferers in the north-west is fundamentally different from that of those in the rest of the country; it is an example of geographical inequity.
It may be that other health authorities do things that are not done in the north-west, but the differences stem not from local accountability to people but from a lack of strategic planning and overall consideration of people's needs. If clinical need were the guide, geography would not normally be, as it often is, the deciding factor in whether or for whom treatment was available.
I reinforce what my hon. Friend the Member for Islington, South and Finsbury (Mr. Smith) said about mixed sex wards. I, too, believe that they are an affront to the dignity of patients, and cause a great deal of distress. I also believe that to cause distress to patients is to be inefficient. Those who consider beds and people as though the people were merely pawns to be moved around are not doing their care any favours. My hon. Friend dealt extremely well with the subject of mixed sex wards, but he did not make particular mention of psychiatric wards. I believe that mixed sex psychiatric wards are especially obnoxious and worrying.
There is much talk about value for money, and I agree entirely that we should obtain it, but that cannot be done if people are treated and cared for by staff who are not appropriately trained; yet that is the case for many of our children.
There is a shortage of paediatricians and other child-trained clinicians in our hospitals. I am shocked that paediatrics is regarded as a Cinderella specialty. Children form a quarter of our population, and what happens to them when they are sick can affect them all their lives. To achieve efficiency, we must ensure good and appropriate treatment for children. Half the children in hospital are in adult wards. That is a disgrace. I do not think that one Conservative Member has mentioned children. That is typical of our neglect of that quarter of the population in health matters.
Many of our sick children, including children with complex disabilities, are now cared for at home. It is especially important to examine the care available for them. They need a community children's nursing service, but in half the country there is no such service. As adults, we expect trained nurses—district and community nurses—to be available. They give us wonderful service. Children have equal need, and should have an equal right to a nursing service trained for their special care, yet half the country has no such service.
Only 10 per cent. of the country has a 24-hour nursing service. Conservative Members who are pointing at their watches should desist. I have sat here for many hours; none of them has been here for as long as I have. It speaks volumes that it is while I am talking about our children and telling the House some uncomfortable facts about how we do not look after them properly, that 1 am interrupted.
Only 10 per cent. of the country has a 24-hour children's community nursing service. That means that 90 per cent. of parents with kids who may have complex difficulties or be terminally ill have no district nurse to call on who is trained to look after children. In the whole country, there are only about 400 such nurses. More urgently need to be trained, and then employed to provide that service. Without appropriately trained staff, we do not get value for money.
I also suggest that we would get value for money if we gave better support to voluntary organisations such as Home-Start, which exists to support families with needs, often health needs. It is wrong that, when people are willing to give time and effort to voluntary work, they should be given the overwhelming burden of perpetual fund-raising. If we are trying to get the best value from every pound expended by the state, we should direct more money at organisations such as Home-Start.
A Conservative Member said that a strong economy was the fundamental need. Of course I agree with that, but it is rich coming from a Government who have presided over constant high unemployment and the destruction of our manufacturing industry. It is not only to provide the wherewithal that we need a strong economy. Economic and social problems make people's health worse, so it is important that we have a strong economy with people in work, because, if people are unemployed, they suffer more sickness.
It is important that we devote our resources to a fairer society. For example, old people still suffer cold in the winter. That is something which I am trying to remedy by the modest Bill I presented today. Let us have a strong economy with the right priorities, so that we have a fairer society. A fairer society is a healthier society.

Mr. Michael Fabricant: The hon. Member for Preston (Mrs. Wise) has allowed me only five minutes, because I know that those on the Front Benches wish to start summing up at about 9.20 pm.
The hon. Lady says that statistics are meaningless, yet, like so many other Opposition Members, she presented a tirade of criticisms of the national health service. The NHS, which is the largest employer in the United Kingdom, is certainly not perfect. Of course it is not. There will always be room for improvement. However, my local chairman always said to me, "If you want to know how the health service is doing, ask someone who has been a patient." That is extremely good advice.
I shall talk briefly about the NHS generally, but more particularly in Lichfield, which I have the honour to represent as part of my constituency. The overriding statistic that Opposition Members choose to ignore is that, in 1979, in the last few months of the Labour Administration, 25 per cent. of all patients waiting for treatment had to wait for hospital treatment for over a year. Now, in 1996, there has been a reduction to only 0.4 per cent. Instead of one in four patients, it is now one in 250 waiting for hospital treatment for longer than one year. Surely that is something of which we must be proud.
The right hon. Member for Livingston (Mr. Cook) said that the acid test of how well the health service is doing is the number of patients who are being treated. In that respect, too, even by the right hon. Gentleman's criterion,


the Government have passed the test. More patients are being treated in primary care and in hospitals than ever before.
Premier Health trust, which is based in Lichfield, runs the Victoria hospital in Lichfield. Waiting times at that hospital have been reduced to the shortest time ever. The majority of patients with non-urgent problems are seen within four weeks for their first appointment. That enables more patients than ever before to be treated.
A rehabilitation unit has been operating for the past 18 months. It provides more appropriate services in responding to need in Lichfield, where previously patients had to go to Birmingham, Sutton Coldfield, Burton or Stafford.
The Victoria hospital has introduced an abdominal ultrascan unit. Since July 1994, when it was introduced, the number of patients scanned has doubled. Obstetric scanning was introduced at the beginning of 1995, enabling mothers to be scanned locally rather than travelling to the district general hospital. The minor injuries unit is meeting patient charter standards for the first time this year.
I am impressed by the number of consultants who now go to the Victoria hospital to treat patients. In the old days, under the old NHS scheme which Labour would like to preserve in aspic, it was always the patients who had to follow the consultants. We now see the consultants following the patients. In the out-patients department of the Lichfield Victoria hospital, 51 consultants are attending each week. For day cases, there are 20 visiting consultants in five different specialties, whereas previously patients would have to travel to Burton, Stafford, Sutton Coldfield or Birmingham.
We have heard cant, hypocrisy and soundbite from Opposition Front Benchers; but when they are asked how much more money Labour will give to support the NHS, they are silent. When Labour is asked how it will restructure the NHS, its Front Benchers are silent. When Labour is asked precisely how it will replace GP fundholding, its Front Benchers are silent. Most telling of all, when Labour is asked how it can defend its stewardship of the NHS under the last Labour Government, when NHS expenditure was cut by more than 30 per cent., Labour Front Benchers fidget and remain silent.
Labour's soundbites cannot guarantee the wealth of the nation, nor the safety of the NHS. As the right hon. Member for Livingston said, the acid test is how many patients are being treated. This Government—this Conservative Government—have passed that test.

Ms Tessa Jowell: I begin by declaring an interest: I have for four years been a member of the parliamentary panel of the Royal College of Nursing.
In winding up the debate, I want to address three issues. The first is the damaging gap between what is actually happening in hospitals up and down the country and the fantasy world in which the Secretary of State and other Ministers believe. Secondly, I shall address the way in which the internal market and fundholding have destroyed a founding principle of our national health service: that

patients are treated according to their need, not their ability to pay or any other consideration. Finally, I shall address the transformation of the culture of the national health service as a result of Government reforms from a public service culture to one that apes that of a commercial organisation.
The debate has demonstrated beyond doubt the scale of the crisis facing our health service this winter. We have heard eloquent evidence from my hon. Friends the Members for Blaenau Gwent (Mr. Smith) and for Morley and Leeds, South (Mr. Gunnell) about the real difficulties facing their constituents in securing treatment this winter. We have heard my hon Friend the Member for Hackney, South and Shoreditch (Mr. Sedgemore) describe the great fears of his constituents about the pre-emption of revenue by the large private finance initiative scheme in east London.
We also heard a surprising confession from the hon. Member for Wimbledon (Dr. Goodson— Wickes), regretting his failure to join us in opposing the devastation of London hospitals four years ago. He eloquently described the medical and academic vandalism that was inflicted at that time—a loss to the capital's medical resources that will be hard to recover.
I want to pick up the reference made by my hon. Friend the Member for Preston (Mrs. Wise) to the iniquity of mixed sex wards and underline the enormous concern about the persistence of such wards in psychiatric hospitals. About 50 per cent. of women who are admitted to psychiatric hospitals have, at some time, been victims of sexual abuse. Research has shown that and shown how damaging to their well-being is the fear of vulnerability to and the possibility of sexual attack while in hospital. There is an urgent need to phase out mixed sex wards and the experiences of women in psychiatric hospitals and of men and women in general wards bear testament to that.
More than anything else, the way in which this winter's crisis has been debated today has marked a clear dividing line between Government and Opposition. Ours is no longer a health service that treats people according to their clinical need—examples from throughout the country have emphasised that. The Government have created that set of circumstances and now shrug off responsibility, saying that the circumstances result from local decision.
The NHS is fast becoming an emergency-only service—a safety net service for those who are acutely ill, while waiting lists lengthen. The crisis—the uncertainty that has been created for patients this winter—is being managed by nods and winks.
We hear reports that regions are telling trusts not to pay creditors after February, as a way to tide things over. I am happy to give way to the Minister if he can confirm that the Government do not intend to break the agreement that creditors are paid within 30 days. I see that the Minister does not wish to answer that point.
Regions are telling trusts that waiting lists should be allowed to lengthen, and that decisions as to how to manage the crisis are down to local managers, so that those who are responsible for the shambles—Ministers—stay as far from blame as possible. It amounts to something when the chief executive of the national health service executive sends a letter to trusts about handling the winter crisis, stating emphatically that it is not a new set of instructions or requirements.
Making the noise, as it is termed, is left to the Secretary of State, as he briefs the media and persuades Tory-supporting chairs of trusts to join his new NHS Network, using their position as public appointees for naked electioneering.
Someone who obviously is not a member of the Tory good news brigade is the chair of the Queens Medical Centre, Nottingham, University Hospital NHS trust. As my hon. Friend the Member for Nottingham, East (Mr. Heppell) said, he has been vocal in expressing his anxieties about his trust's capacity to treat patients this winter.
What is happening at the Queens medical centre in Nottingham helps us to understand the distortions in the health service. On 1 November, the centre stopped taking any routine elective admissions from non-fundholding GPs. As only 23 per cent. of Nottingham's population is covered by fundholders, 77 per cent. of the population now cannot have surgery unless they can be admitted as an emergency. That means that the centre has empty beds, so nearby Derbyshire, where 90 per cent. of GPs are fundholders, is referring its patients for treatment in the empty beds.
In 1990, the reforms were introduced with much-vaunted claims that the money would follow the patient. Patients now follow the money—where their GPs are fundholders. The chances of getting elective surgery done before next April are increasingly remote anywhere in the country unless a person is the patient of a fundholder, regardless of what is wrong with him.
King's College hospital provides a local example of the two-tier national health service, described as "an everyday reality" by Derek Smith, the chief executive. At the public meeting earlier this year, he said:
Having succeeded in driving down waiting lists for all patients to twelve months it is with regret that we now see waiting times rising again for patients from Lambeth, Southwark and Lewisham. We are a national and regional centre of excellence but we live and work at the centre of our local community from which patients have longer waits than those from outside the area.
This is in effect a two-tier NHS…the last few years King's has seen major expansion and development as part of an ongoing modernisation programme. We have new, high-tech facilities such as our day surgery centre which is under-used while there arc patients on waiting lists that it can care for.
A surgeon at King's College hospital, which treats my constituents, recently sent me a letter that had been circulated to all senior registrars, registrars and consultants in the surgery and critical care groups. They are working closely with the marketing department to attract additional ECRs and fundholding GP activity. They are concerned to draw attention to the clinical urgency of some of the cases that will face extended waits as a result of insufficient contract volumes. That is especially pronounced in neurology, where many cases involve following up, treating or diagnosing cancer.
The vascular clinic will now, on Wednesday mornings and Friday afternoons, book in only the patients of GP fundholders and extra-contractual referrals. I should like Ministers to tell me how I can justify all that to my constituents.
Of course people suffer as a result. The need for routine surgery becomes a necessity for emergency treatment when, for instance, a man with angina has a heart attack, or a man with prostate problems becomes unable to pass urine. A cardiologist in Bedfordshire recently observed

that his patients waiting for heart surgery are more likely to die on the waiting list than they are to die of the operation.
There is another inequity in the system. Fundholding GPs do not have to meet the costs of emergency treatment for their patients. As emergencies increase, therefore, the costs are a further drain on the resources of health authorities, not fundholders. So health authorities are faced with an increasing number of emergencies and with meeting, where possible, the costs of elective surgery for the patients of non-fundholding GPs.
All this represents more broken promises. Moorfields Eye hospital has just extended its out-patient waiting time to 26 weeks, in clear breach of the patients charter standard of 13 weeks.
This may be bad news for patients; it is certainly good news for private providers and the insurance companies, for which insecurity and lengthening waiting lists are the best possible recruiting sergeants. Increasing numbers of people are paying twice for their health care. What is so damaging is that no one in the Conservative party takes the problem seriously. The Government live in a world of make-believe. Most recently, the Secretary of State published a White Paper setting out, as he called it, his credo for the national health service. In it we read fairy tales about the triumphs of the NHS. There have certainly been some triumphs, but they are achieved by the dedication of staff—despite, not because of, this Government.
The White Paper failed to mention elderly patients waiting on trolleys or patients re-admitted after premature discharge—or lengthening waiting lists, cancelled operations or the winter crisis. All these are the daily facts of life for staff and patients alike. Furthermore, there was no mention of those great Government icons: competition and the market. The Government believe that they have been a howling success. They should perhaps take seriously the findings of the recent "British Social Attitudes" survey. When asked whether they thought that the health service had improved, 81 per cent. of those interviewed said that they saw no improvement and 49 per cent. believed that things had got worse or much worse.

Mr. Fabricant: Is the hon. Lady aware of the poll of patients who had recently been treated by the health service, over 80 per cent. of whom said that they thought the health service had improved in the past few years? Is she not merely reflecting Labour party propaganda? How effective that has been in convincing people who have not been treated that the health service is not successful.

Ms Jowell: The hon. Gentleman makes my point. There is a view of reality that is shared by Conservative Members, and there is the real world outside, across the bridge at St. Thomas's hospital, at King's College hospital, Guy's hospital and Chase Farm hospital.
At the root of all that is the fact that the Tories do not really believe in the national health service. They voted against it 50 years ago. They have come to see it as inevitable, but they do not see it as desirable. The Secretary of State continues to protest that his intentions are good. Perhaps they are; let us give him the benefit of the doubt. But the truth is that his heart is not in it. For the Conservatives, state medicine is like state education: the odd hon. Member may use it, but most do not.
At Richmond house, where the Secretary of State sits, in a world where the raw pain and hard choices are sanitised, and where management-speak has taken over from patient care, a particular language is spoken. Nasty words such as "patients", "pain" and "waiting lists" have been eliminated from the vocabulary.
I was recently sent a copy of the minutes of the management board, the most senior board responsible for the NHS. One need read no further than those minutes to understand that patients have simply been written out of the script. Nowhere in the long deliberations of that meeting are patients mentioned. My hon. Friend the Member for Preston made the point that the Government no longer speak about patients, but speak instead about finished consultant episodes.
To give the House a flavour of the way in which the board speaks, I quote from the document. It states:
The Board considered the areas of the country which faced the most difficulties. It agreed that support must be given to the NHS to manage through these problems without impacting on the many improvements already achieved … A more open position on prioritising was inevitable.
What on earth does that mean?
There is no mention of patients in the letters sent to trusts and health authorities about the winter crisis. The NHS is aping the culture of a commercial organisation and failing both patients and staff in the process.
I received a letter today from the Royal College of Midwives expressing great concern at the fact that "Changing Childbirth" was becoming less viable. That is supported by both sides of the House as the way forward in maternity care. "Changing Childbirth" is threatened by the recruitment and retention crisis hitting midwifery.
The people of this country will have to get through this winter. There will be heartache and anger as clinical priorities are determined by the crude mechanisms of a false market. In the spring there will be a general election. That will be the last chance for our national health service.
Labour will rid the health service of the dogma-driven reforms foisted on it by the Government. It will mend the fractures that have shattered the NHS into hundreds of small businesses. We will rebuild a health service in which our constituents can have confidence and of which the country can again be proud.

The Minister for Health (Mr. Gerald Malone): The hon. Member for Dulwich (Ms Jowell) had an opportunity to set out some of her party's policies, as the country approaches an election, about the future of the national health service, but we heard absolutely nothing about what the Labour party would do. The same was also true of the hon. Member for Islington, South and Finsbury (Mr. Smith), who opened the debate.
The emptiness of the Labour party and its policies on the national health service characterised the debate. All that the hon. Lady did in winding up the debate was to reiterate threats about the privatisation of the NHS and the hidden agenda for the NHS that the Government were supposed to have in 1979, 1983, 1987, 1992 and 1997. The hon. Lady will doubtless make the same speech about our hidden agenda when we come up for re-election again in 2002, still supporters of our national health service.
Our future for the NHS is contained in "secret documents" called White Papers, which appear in public and are debated. It also appears in things called Bills, which come before the House—currently before the House of Lords—in terms of bringing forward primary care. It is astonishing that not one Opposition Member even bothered during the debate to mention what is at the centre of the debate on our health service today—the future of a primary care-led NHS—and that a Bill has been presented to Parliament. Not a word did we hear from Labour Members about that, what their thoughts about it were and how they would take it forward. We will talk about that later in my speech, I promise.
We also failed to hear the Labour party's pledge on spending. Again, the hon. Member for Islington, South and Finsbury totally refused to match the promise that made by my right hon. Friend the Prime Minister and repeated by my right hon. Friend the Secretary of State.

Mr. Chris Smith: How much?

Mr. Malone: It is a real-terms increase year on year on year on year for the next Parliament, just as we have done in this Parliament and in the Parliaments before that. If the hon. Gentleman thinks that getting down to specifics on health spending will do him any good, he should look at the record of the last Labour Government. Not only was that pledge not honoured in its final years, but—for the first time in the history of the health service, I believe—the percentage of gross domestic product spent on health care in this country slipped from 4.8 per cent. to 4.7 per cent. The figure has now been increased to 5.9 per cent.

Mr. Smith: Can the Minister confirm two things? First, will he confirm that the percentage of GDP currently spent on the national health service is less than it was at the general election in 1992? Secondly, will he confirm that the last Labour Government raised national health service spending by more in real terms in its five years than has happened in the past five years?

Mr. Malone: The hon. Gentleman made much of his party's custody of the health service while Labour was in Government. In Government, we have gone from 4.7 per cent. of GDP to 5.9 per cent. The hon. Gentleman cannot fudge that.
It beggars belief that, even in the winding up of the debate, when the hon. Gentleman intervenes he does not take the opportunity to repeat or match the pledge that the Prime Minister has given. The hon. Gentleman made much of Red Book figures—outline figures —and the House knows that they are not normally the figures lit upon at the end of the day. He said that a 0.1 per cent. increase in health spending in real terms was tiny. If that is so, will he now pledge to match even that minimalist amount in real terms spending on the health service if he were in Government? I invite him to do so now, but he will not, as I am sure that the House will have recognised.
The truth is that the Tories are now running the agenda on the NHS. That is what I believe that the hon. Member for Hartlepool (Mr. Mandelson), Labour's spin doctor, may well have said. I can hear it characterising the debate. "Come on, Chris. The Tories are running the agenda on the NHS. Even if we can't promise anything—and you


can't promise anything—let's simply declare a crisis." After all, that is what the Labour party has done for 17 years, but I can tell the hon. Gentleman that it has not done the Labour party any good.
Many right hon. and hon. Members have participated in the debate. I shall refer to a number of the contributions and try to answer the points that were made.
My right hon. Friend the Member for Sutton Coldfield (Sir N. Fowler) was Secretary of State for Social Services for six years and he drew on that extensive experience in his speech. He pointed out that trust hospitals are able to respond to problems, and he used a constituency example to illustrate very clearly how trusts can make rapid changes in order to improve service provision.
The hon. Member for Southwark and Bermondsey (Mr. Hughes) raised two points. First, he referred to mental health and asked whether the Government consider it a priority. I assure him that we do. In the current year, £95 million in additional revenue has been devoted to improving mental health services—£53 million from health authorities, £10 million from the mental health challenge fund, £10 million in matching health authority funding, and £20 million from the mental illness specific grant, plus a £2 million contribution from local authorities. I hope that he will accept that as proof of our earnest intentions and our acceptance of mental health as a priority.
The hon. Gentleman also mentioned backlog maintenance. That figure must be put in perspective, as it represents only 3 per cent. of the replacement cost of NHS estates. He should bear in mind also the fact that the NHS is responsible for more than 700 listed buildings, which is more than the National Trust.
The hon. Member for Blaenau Gwent (Mr. Smith) highlighted problems with the South and East Wales Ambulance NHS trust. I assure him that my right hon. Friend the Secretary of State for Wales is taking a close interest in the matter.
My hon. Friend the Member for Broxbourne (Mrs. Rowe) mentioned a primary care-led NHS and set out the improvements that that will bring—including quicker access and new clinics located closer to patients. The legislation that is currently before Parliament: will encourage further developments in that area. It embraces the principle that patient care should take place closer to the patient where that is clinically appropriate. Although Labour Members said nothing about it, the move is welcomed by the medical profession and by those who are involved in primary care delivery.
The hon. Member for Nottingham, East (Mr. Heppell) raised two points. First, he asked what was happening at the Queens Medical Centre NHS trust. That trust is increasing the treatment that it provides, and the number of cases rose by 2.2 per cent. last year. Trusts up and down the country are facing pressures and difficulties, but I hope that the hon. Gentleman will view current events in the context of an overall increase in treatment. Secondly, the allocation for his local health authority increased by £15 million last year— which is the largest percentage increase in the Trent region.
The hon. Member for Mid-Ulster (Rev. William McCrea) made the very good point that we must follow policies with real finance. In so doing, he put the Labour party on the spot as he clearly understands that there can be no pledges regarding the health service unless they are

followed with real cash commitments. He raised several other matters that are the responsibility of my right hon. Friend the Secretary of State for Northern Ireland and I shall ensure that they are drawn to his attention.
I do not usually enjoy the contributions of the hon. Member for Morley and Leeds, South (Mr. Gunnell), but I think that he has been taking tablets to relieve his gloom because there was some optimism in his speech when he referred to positive primary care developments and hospital improvements in his constituency. I thought that we might be persuading him to our point of view, but, sadly, the clouds soon gathered again. Despite his praise for the health service, he raised several specific points. He referred to increased intensive care and high dependency bed provision. West Yorkshire is allocating £4 million to achieve that increase and my right hon. Friend the Secretary of State announced measures earlier this year to increase the number of paediatric intensive care beds by 20 per cent.

Mr. Gunnell: rose—

Mr. Malone: I shall not give way. The hon. Gentleman may raise a specific point with me later, but I must make progress now.
My hon. Friend the Member for Harlow (Mr. Hayes) vigorously attacked the Labour party's lack of policies. I agree with him, as today Opposition Members again indulged in shroud-waving. My hon. Friend referred to The Independent article attacking Labour, and pointed out correctly that we have taken over the health care agenda, which the Labour party always claimed for itself.
My hon. Friend the Member for Wimbledon (Dr. Goodson-Wickes) asked for specific reassurances about the future of the Bart's site. As he knows, the matter is being considered by a committee that is due to report in the not too distant future. He will be kept up to date with developments in that important area.

Dr. Goodson-Wickes: Will my hon. Friend give way?

Mr. Malone: I am afraid that I do not have time.
The hon. Member for Belfast, South (Rev. Martin Smyth) asked about managers who receive salaries that are disproportionate to the task involved. The salary of an individual NHS trust chief executive is a matter for the committee of that trust. He also asked about emergency admissions. Concern about that has been expressed, and the problem is not explained by looking at the situation across the service. However, the matter is being investigated. Good management can often cope with an unexpected rise in emergency admissions.
My hon. Friend the Member for Southport (Mr. Banks) raised a constituency point about a private finance initiative. He asked for my assurance that I would keep the matter under review. I will watch developments in his constituency. I understand how important this is to him: he is a great campaigner on behalf of his constituents, and draws such matters to the attention of Ministers. I promise him that I will keep it well within my view.
The hon. Member for Preston (Mrs. Wise) raised a point that deserves the House's attention. She talked about the number of finished consultant episodes as if it was a magic figure that was irrelevant. I remind her—and perhaps the House—of their history. She may have forgotten that the move towards finished consultant


episodes as a true measure of performance in the NHS was recommended by the working group chaired by Edith Körner. The hon. Lady may also have forgotten that the then Department of Health and Social Security, in its consultation document, proposed a joint steering group to examine this matter, which was established in February 1979. It was welcomed by Labour's Royal Commission on the national health service, which said:
Improvements in information will initially require additional expenditure on administration but we expect the quality of decision making would thereby be much improved.
A journalist called Ann Clwyd happened to be a member of that commission.
The use of proper statistics was put in place by a Labour Government and was carried on by the Körner committee. They are the truest measure of NHS activity. It does the hon. Lady and her hon. Friends no good at all to denigrate the increased activity of the NHS by saying that the statistics are false. They are not. The hon. Member for Islington, South and Finsbury said that this was a Labour idea in the first place. Similarly, the right hon. Member for Kingston upon Hull, East (Mr. Prescott) keeps telling us that the private finance initiative was his idea in the first place. On investigation, it seems that finished consultant episodes started off their life in the dying days of a Labour Government.
Labour Members did not touch on their plans for the future of the health service. They were silent on that. They tried their usual trick of denigrating the achievements of people in the health service. They set those achievements at naught.
Let me set out what I think people take as the true benchmarks of the success of a national health service, and the benchmarks of a Government's commitment to it. First, I shall deal with the work force. How many more nurses are there in the health service since the Government entered office in 1979? There are 55,000 more nurses, which is not the figure that Labour Members consistently peddle, even though they have been told time and again that their figures and the basis on which they are calculated are false. If the hon. Member for Islington, South and Finsbury wants to test me further, I can tell him that since the reforms there has been a smaller increase of 1,000 or 2,000, so he is wrong on that as well.
The number of hospital staff has increased from 48,590 to 55,350, which is a huge increase. That investment in the medical profession has been financed as a result of the Government's determined efforts. Let us pick another benchmark that Labour Members are always keen to talk about when it suits them—waiting times. It is absurd to use the overall number of people who are waiting for operations as the benchmark of the health service's success. As a service grows, and as more and more people are treated by it, so the number waiting for treatment at any given time will increase in absolute terms. What the hon. Member for Islington, South and Finsbury fails to recognise is that whereas 195,185 people were waiting for more than a year in 1979, in 1996 the figure is 4,576. I must point out to the hon. Gentleman again that it is the length of time for which someone waits for an operation and treatment that counts.
Earlier, an Opposition Member who is not present now said, from a sedentary position, that we were cheating with our figures, because we were not including out-patient

waiting times. But the Government pass that benchmark test as well, with flying colours: 85 per cent. of patients are now seen within 13 weeks at out-patient clinics, which is a great achievement.
Another thing that we did not hear about from the Opposition is their policy on GP fundholding, which changes regularly with every change in Opposition Front-Bench spokesmen. The language has changed—and I hope that the nation understands what that language means as well as GP fundholders do. First the Opposition were going to abolish fundholding; then they were going to replace it. Now, I understand that—following a speech made in Harrogate by the hon. Member for Islington, South and Finsbury to the Association of Fundholding Practices—we have heard something else: it is going to evolve.
It is no good for the hon. Gentleman to go to conferences of GP fundholders and praise them for their achievements, saying that he will listen to what is said about fundholding in the future, and then to come to the House and make a speech that denigrates those achievements in the clearest and most absolute way. Whatever words he and his hon. Friends use about GP fundholding, my goodness, we know what replacing it, evolving it or abolishing it actually means. If anyone who was a member of Stalin's Politburo was told that he would be evolved or replaced, he knew exactly what would happen—and that is precisely what GP fundholders understand.
Let me end not just by confirming the Government's commitment to the White Paper that my right hon. Friend the Secretary of State has rightly presented—indicating confirmation of our adherence to the principles of the NHS—but by talking about the primary care-led NHS. It is a tremendous achievement for GPs across the country, both fundholders and non-fundholders, that we are now in a position to proceed with a primary care-led Bill that will make a primary care-led NHS a reality.
I object to Opposition Members' denigration of what has been happening, both in innovation in primary care through fundholders and in other ways. A policy of denigration is a disgrace, because it betrays the work of all who perform services in the NHS.
I recently wrote to the right hon. Member for Sedgefield (Mr. Blair), the Leader of the Opposition, raising with him an issue that he had raised at Prime Minister's Question Time. On that occasion, the right hon. Gentleman made yet another unfounded assertion about our NHS, saying that maternity services had declined under the present Government in recent years. [HON. MEMBERS: "Hear, hear."] I note that that is given some support by the Labour party. I hope that the midwives who deliver maternity services, and all who have worked hard to develop changing childbirth techniques—

Ms Jowell: Will the Minister give way?

Mr. Malone: Not now.
I hope that all those who have improved the quality of maternity services will understand how little the Leader of the Opposition values them.
I have issued a challenge to the Leader of the Opposition, and I issue it to the hon. Member for Islington, South and Finsbury as well. Those who criticise the NHS should put up or shut up. They should give us the facts and figures, so that we may respond. What is intolerable to all who work in


the service is the denigration of their achievements through unfounded accusations, which has been the tactic of the Labour party in recent years. It has had an opportunity today to explain to the House and to the electorate whether it has a vision for the future of the NHS. It has none. It is this party and this Government who have that vision and who will carry it forward in the next Parliament.

Question put, That the original words stand part of the Question:—

The House divided: Ayes 268, Noes 274.

Division No. 16]
[9.59 pm


AYES


Abbott, Ms Diane
Davies, Chris (Littleborough)


Ainger, Nick
Davies, Denzil (Llanelli)


Ainsworth, Robert (Cov'try NE)
Davies, Ron (Caerphilly)


Allen, Graham
Davis, Terry (B'ham Hodge H)


Alton, David
Denham, John


Anderson, Ms Janet (Ros'dale)
Dewar, Donald


Armstrong, Ms Hilary
Dixon, Don


Ashdown, Paddy
Dobson, Frank


Austin-Walker, John
Donohoe, Brian H


Banks, Tony (Newham NW)
Dowd, Jim


Barnes, Harry
Dunwoody, Mrs Gwyneth


Barron, Kevin
Eastham, Ken


Battle, John
Etherington, Bill


Bayley, Hugh
Evans, John (St Helens N)


Beckett, Mrs Margaret
Ewing, Mrs Margaret


Beggs, Roy
Fatchett, Derek


Beith, A J
Field, Frank (Birkenhead)


Bell, Stuart
Flynn, Paul


Benn, Tony
Foster, Derek


Bennett, Andrew F
Foster, Don (Bath)


Benton, Joe
Foulkes, George


Bermingham, Gerald
Fraser, John


Berry, Roger
Fyfe, Mrs Maria


Betts, Clive
Galbraith, Sam


Boateng, Paul
Galloway, George


Bradley, Keith
Gapes, Mike


Bray, Dr Jeremy
Garrett, John


Brown, Nicholas (Newcastle E)
Gerrard, Neil


Burden, Richard
Gilbert, Dr John


Byers, Stephen
Godman, Dr Norman A


Caborn, Richard
Godsiff, Roger


Callaghan, Jim
Golding, Mrs Llin


Campbell, Mrs Anne (C'bridge)
Graham, Thomas


Campbell, Ronnie (Blyth V)
Grant, Bernie (Tottenham)


Campbell-Savours, D N
Griffiths, Nigel (Edinburgh S)


Canavan, Dennis
Griffiths, Win (Bridgend S)


Cann, Jamie
Grocott, Bruce


Chisholm, Malcolm
Gunnell, John


Clapham, Michael
Hain, Peter


Clarke, Eric (Midlothian)
Hall, Mike


Clarke, Tom (Monklands W)
Hanson, David


Clelland, David
Harman, Ms Harriet


Clwyd, Mrs Ann
Harvey, Nick


Coffey, Ms Ann
Henderson, Doug


Connarty, Michael
Hendron, Dr Joe


Cook, Robin (Livingston)
Heppell, John


Corbett, Robin
Hill, Keith (Streatham)


Corbyn, Jeremy
Hinchliffe, David


Corston, Ms Jean
Hoey, Miss Kate


Cousins, Jim
Hogg, Norman (Cumbernauld)


Cox, Tom
Home Robertson, John


Cummings, John
Hood, Jimmy


Cunliffe, Lawrence
Howarth, Alan (Statf'd-on-A)


Cunningham, Jim (Cov'try SE)
Howarth, George (Knowsley N)


Cunningham, Ms R (Perth Kinross)
Howells, Dr Kim


Dafis, Cynog
Hoyle, Doug


Dalyell, Tam
Hughes, Kevin (Doncaster N)


Darling, Alistair
Hughes, Robert (Ab'd'n N)


Davidson, Ian
Hughes, Roy (Newport E)


Davies, Bryan (Oldham C)
Hughes, Simon (Southwark)





Ingram, Adam
Pickthall, Colin


Jackson, Ms Glenda (Hampst'd)
Pike, Peter L


Jackson, Mrs Helen (Hillsborough)
Pope, Greg


Jamieson, David
Powell, Sir Raymond (Ogmore)


Janner, Greville
Prentice, Mrs B (Lewisham E)


Jenkins, Brian D (SE Staffs)
Prentice, Gordon (Pendle)


Jones, Barry (Alyn  D'side)
Primarolo, Ms Dawn


Jones, Ieuan Wyn (Ynys Môn)
Purchase, Ken


Jones, Jon Owen (Cardiff C)
Quin, Ms Joyce


Jones, Dr L (B'ham Selly Oak)
Radice, Giles


Jones, Martyn (Clwyd SW)
Randall, Stuart


Jones, Nigel (Cheltenham)
Raynsford, Nick


Jowell, Ms Tessa
Reid, Dr John


Kaufman, Gerald
Rendel, David


Keen, Alan
Robertson, George (Hamilton)


Khabra, Piara S
Robinson, Geoffrey (Cov'try NW)


Kilfoyle, Peter
Roche, Mrs Barbara


Lestor, Miss Joan (Eccles)
Rogers, Allan


Liddell, Mrs Helen
Rooker, Jeff


Litherland, Robert
Rooney, Terry


Livingstone, Ken
Ross, Ernie (Dundee W)


Lloyd, Tony (Stretf'd)
Rowlands, Ted


Llwyd, Elfyn
Ruddock, Ms Joan


Loyden, Eddie
Salmond, Alex


Lynne, Ms Liz
Sedgemore, Brian


McAllion, John
Sheerman, Barry


McAvoy, Thomas
Sheldon, Robert


McCartney, Ian (Makerf'ld)
Shore, Peter


Macdonald, Calum
Simpson, Alan


McFall, John
Skinner, Dennis


McKelvey, William
Smith, Andrew (Oxford E)


Mackinlay, Andrew
Smith, Chris (Islington S)


McLeish, Henry
Smith, Llew (Blaenau Gwent)


McMaster, Gordon
Smyth, Rev Martin (Belfast S)


McNamara, Kevin
Soley, Clive


MacShane, Denis
Spearing, Nigel


McWilliam, John
Speller, John


Madden, Max
Squire, Ms R (Dunfermline W)


Maddock, Mrs Diana
Steinberg, Gerry


Maginnis, Ken
Stevenson, George


Mendelson, Peter
Strang, Dr Gavin


Marek, Dr John
Straw, Jack


Marshall, David (Shettleston)
Sutcliffe, Gerry


Marshall, Jim (Leicester S)
Taylor, Mrs Ann (Dewsbury)


Martin, Michael J (Springburn)
Taylor, Matthew (Truro)


Martlew, Eric
Thompson, Jack (Wansbeck)


Maxton, John
Thurnham, Peter


Meacher, Michael
Timms, Stephen


Meale, Alan
Tipping, Paddy


Michael, Alun
Touhig, Don


Michie, Bill (Shef'ld Heeley)
Trickett, Jon


Michie, Mrs Ray (Argyll Bute)
Turner, Dennis


Milburn, Alan
Tyler, Paul


Miller, Andrew
Vaz, Keith


Mitchell, Austin (Gt Grimsby)
Walker, Sir Harold


Molyneaux, Sir James
Wallace, James


Moonie, Dr Lewis
Walley, Ms Joan


Morgan, Rhodri
Wardell, Gareth (Gower)


Morley, Elliot
Wareing, Robert N


Morris, Alfred (Wy'nshawe)
Watson, Mike


Morris, Ms Estelle (B'ham Yardley)
Wicks, Malcolm


Morris, John (Aberavon)
Wigley, Dafydd


Mowlam, Ms Marjorie
Williams, Alan (Swansea W)


Mudie, George
Williams, Alan W (Carmarthen)


Mullin, Chris
Wilson, Brian


Murphy, Paul
Winnick, David


Oakes, Gordon
Wise, Mrs Audrey


O'Brien, Mike (N Warks)
Worthington, Tony


O'Brien, William (Normanton)
Wray, Jimmy


Olner, Bill
Wright, Dr Tony


O'Neill, Martin
Young, David (Bolton SE)


Orme, Stanley
Tellers for the Ayes:


Paisley, Rev Ian
Mrs. Jane Kennedy and


Parry, Robert
Ms Angela Eagle.


Pearson, Ian



Pendry, Tom







NOES


Ainsworth, Peter (E Surrey)
Evans, Jonathan (Brecon)


Alexander, Richard
Evans, Nigel (Ribble V)


Alison, Michael (Selby)
Evans, Roger (Monmouth)


Allason, Rupert (Torbay)
Evennett, David


Arbuthnot, James
Faber, David


Arnold, Jacques (Gravesham)
Fabricant, Michael


Ashby, David
Fenner, Dame Peggy


Atkins, Robert
Field, Barry (Isle of Wight)


Atkinson, Peter (Hexham)
Fishburn, Dudley


Baker, Kenneth (Mole V)
Forman, Nigel


Baker, Nicholas (N Dorset)
Forth, Eric


Baldry, Tony
Fowler, Sir Norman


Banks, Matthew (Southport)
Fox, Dr Liam (Woodspring)


Banks, Robert (Harrogate)
Fox, Sir Marcus (Shipley)


Bates, Michael
Freeman, Roger


Batiste, Spencer
French, Douglas


Bellingham, Henry
Fry, Sir Peter


Beresford, Sir Paul
Gale, Roger


Biffen, John
Gallie, Phil


Body, Sir Richard
Gardiner, Sir George


Booth, Hartley
Garel-Jones, Tristan


Boswell, Tim
Garnier, Edward


Bottomley, Peter (Eltham)
Gill, Christopher


Bottomley, Mrs Virginia
Gillan, Mrs Cheryl


Bowden, Sir Andrew
Goodlad, Alastair


Boyson, Sir Rhodes
Goodson-Wickes, Dr Charles


Brandreth, Gyles
Gorst, Sir John


Brazier, Julian
Grant, Sir Anthony (SW Cambs)


Bright, Sir Graham
Greenway, Harry (Ealing N)


Brooke, Peter
Griffiths, Peter (Portsmouth N)


Brown, Michael (Brigg Cl'thorpes)
Grylls, Sir Michael


Browning, Mrs Angela
Gummer, John


Bruce, Ian (S Dorset)
Hague, William


Burns, Simon
Hamilton, Sir Archibald


Burt, Alistair
Hampson, Dr Keith


Butcher, John
Hanley, Jeremy


Butler, Peter
Hannam, Sir John


Butterfill, John
Hargreaves, Andrew


Carlisle, John (Luton N)
Harris, David


Carlisle, Sir Kenneth (Linc'n)
Haselhurst, Sir Alan


Carrington, Matthew
Hawkins, Nick


Carttiss, Michael
Hawksley, Warren


Cash, William
Hayes, Jerry


Channon, Paul
Heald, Oliver


Chapman, Sir Sydney
Heath, Sir Edward


Clappison, James
Heathcoat-Amory, David


Clark, Dr Michael (Rochf'd)
Hendry, Charles


Clarke, Kenneth (Rushcliffe)
Hicks, Sir Robert


Clifton-Brown, Geoffrey
Higgins, Sir Terence


Coe, Sebastian
Hogg, Douglas (Grantham)


Colvin, Michael
Horam, John


Congdon, David
Hordern, Sir Peter


Conway, Derek
Howard, Michael


Coombs, Anthony (Wyre F)
Howell, David (Guildf'd)


Coombs, Simon (Swindon)
Howell, Sir Ralph (N Norfolk)


Cope, Sir John
Hughes, Robert G (Harrow W)


Cormack, Sir Patrick
Hunt, David (Wirral W)


Couchman, James
Hunt, Sir John (Ravensb'ne)


Cran, James
Hunter, Andrew


Currie, Mrs Edwina
Hurd, Douglas


Curry, David
Jack, Michael


Davies, Quentin (Stamf'd)
Jackson, Robert (Wantage)


Davis, David (Boothferry)
Jenkin, Bernard (Colchester N)


Day, Stephen
Jessel, Toby


Deva, Nirj Joseph
Jones, Gwilym (Cardiff N)


Devlin, Tim
Jones, Robert B (W Herts)


Dorrell, Stephen
Kellett-Bowman, Dame Elaine


Douglas-Hamilton, Lord James
Key, Robert


Dover, Den
King, Tom


Duncan Smith, Iain
Kirkhope, Timothy


Dunn, Bob
Knight, Mrs Angela (Erewash)


Dykes, Hugh
Knight, Greg (Derby N)


Elletson, Harold
Knight, Dame Jill (Edgbaston)


Evans, David (Welwyn Hatf'ld)
Knox, Sir David





Kynoch, George
Sainsbury, Sir Timothy


Lait, Mrs Jacqui
Shaw, David (Dover)


Lang, Ian
Shaw, Sir Giles (Pudsey)


Legg, Barry
Shephard, Mrs Gillian


Leigh, Edward
Shepherd, Sir Colin (Heref'd)


Lennox-Boyd, Sir Mark
Shersby, Sir Michael


Lester, Sir Jim (Broxtowe)
Sims, Sir Roger


Lidington, David
Skeet, Sir Trevor


Lilley, Peter
Smith, Tim (Beaconsf'ld)


Lloyd, Sir Peter (Fareham)
Soames, Nicholas


Lord, Michael
Speed, Sir Keith


Luff, Peter
Spencer, Sir Derek


MacGregor, John
Spicer, Sir Jim (W Dorset)


MacKay, Andrew
Spicer, Sir Michael (S Worcs)


Maclean, David
Spring, Richard


McLoughlin, Patrick
Sproat, Iain


McNair-Wilson, Sir Patrick
Squire, Robin (Hornchurch)


Madel, Sir David
Stanley, Sir John


Maitland, Lady Olga
Steen, Anthony


Malone, Gerald
Stephen, Michael


Mans, Keith
Stern, Michael


Marland, Paul
Stewart, Allan


Marlow, Tony
Streeter, Gary


Marshall, John (Hendon S)
Stott, Roger


Marshall, Sir Michael (Arundel)
Sumberg, David


Martin, David (Portsmouth S)
Sweeney, Walter


Mawhinney, Dr Brian
Sykes, John


Mellor, David
Tapsell, Sir Peter


Merchant, Piers
Taylor, Ian (Esher)


Mitchell, Andrew (Gedling)
Taylor, John M (Solihull)


Moate, Sir Roger
Taylor, Sir Teddy


Monro, Sir Hector
Temple-Morris, Peter


Montgomery, Sir Fergus
Thomason, Roy


Moss, Malcolm
Thompson, Sir Donald (Calder V)


Needham, Richard
Thompson, Patrick (Norwich N)


Nelson, Anthony
Thornton, Sir Malcolm


Neubert, Sir Michael
Townend, John (Bridlington)


Newton, Tony
Townsend, Cyril D (Bexl'yh'th)


Nicholson, David (Taunton)
Tracey, Richard


Norris, Steve
Tredinnick, David


Onslow, Sir Cranley
Trend, Michael


Oppenheim, Phillip
Twinn, Dr Ian


Ottaway, Richard
Vaughan, Sir Gerard


Page, Richard
Waldegrave, William


Paice, James
Walden, George


Patnick, Sir Irvine
Walker, Bill (N Tayside)


Patten, John
Waller, Gary


Pattie, Sir Geoffrey
Wardle, Charles (Bexhill)


Pawsey, James
Waterson, Nigel


Peacock, Mrs Elizabeth
Watts, John


Pickles, Eric
Whitney, Ray


Porter, David
Whittingdale, John


Powell, William (Corby)
Widdecombe, Miss Ann


Rathbone, Tim
Wiggin, Sir Jerry


Redwood, John
Wilkinson, John


Renton, Tim
Wilshire, David


Richards, Rod
Winterton, Mrs Ann (Congleton)


Riddick, Graham
Winterton, Nicholas (Macclesf'ld)


Robathan, Andrew
Wolfson, Mark


Roberts, Sir Wyn
Wood, Timothy


Robinson, Mark (Somerton)
Yeo, Tim


Roe, Mrs Marion
Young, Sir George


Rowe, Andrew
Tellers for the Noes:


Rumbold, Dame Angela
Mr. Bowen Wells and


Sackville, Tom
Mr. Roger Knapman.

Question accordingly negatived.

Question, That the proposed words be there added, put forthwith, pursuant to Standing Order No. 30 (Questions on amendments), and agreed to.

MR. DEPUTY SPEAKER forthwith declared the main Question, as amended, to be agreed to.

Resolved,


That this House believes the National Health Service is one of the success stories of modern Britain and is wholeheartedly committed to developing the NHS on the basis of its founding principles of universality, high quality and availability on the basis of clinical need, without regard for the patient's ability to pay: expresses its support for the Government's initiatives to release £300 million from unnecessary NHS administration; welcomes both the Government's further plans to develop NHS primary care and the recent White Paper A Service With Ambitions, which sets out a medium-term framework for a high-quality patient-focused NHS; and welcomes the Government's pledge to spend more money on the NHS, over and above inflation, for each year of the five years of the next Parliament.

EUROPEAN COMMUNITY DOCUMENTS

Motion made, and Question put forthwith, pursuant to Standing Order No. 102(9) (European Standing Committees),

CINEMA AND TELEVISION PRODUCTION

That this House takes note of European Community Document No. 12357/95 relating to the establishment of a European Guarantee Fund to promote cinema and television production; and supports the Government's view that such a fund can only be successful in strengthening the audiovisual industries if it is privately funded and run on wholly commercial lines.—[Mr. Brandreth.]

Question agreed to.

Motion made, and Question put forthwith, pursuant to Standing Order No. 102(9) (European Standing Committees),

IDENTIFICATION OF CATTLE AND LABELLING OF BEEF AND BEEF PRODUCTS

That this House takes note of European Community Document No. 10495/96, relating to the identification and registration of bovine animals, and the labelling of beef and beef products; and supports the principle of improved traceability for cattle as a means to improve consumer confidence in beef.—[Mr. Brandreth.]

Question agreed to.

DELEGATED LEGISLATION

Mr. Deputy Speaker (Mr. Michael Morris): With permission, I shall put together the following two motions relating to delegated legislation.

Motion made, and Question put forthwith, pursuant to Standing Order No. 101(6) (Standing Committees on Delegated Legislation),

NORTHERN IRELAND

That the draft Succession (Northern Ireland) Order 1996, which was laid before this House on 24th October, be approved.

That the draft Rates (Amendment) (Northern Ireland) Order 1996, which was laid before this House on 24th October, be approved.—[Mr. Brandreth.]

Question agreed to.

Motion made, and Question put forthwith, pursuant to Standing Order No. 101(6) (Standing Committees on Delegated Legislation),

DENTISTS

That the draft Dental Auxiliaries (Amendment) Regulations 1996, which were laid before this House on 30th October, be approved.—[Mr. Brandreth.]

Question agreed to.

Water Meters (Norwich)

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Brandreth.]

Mr. Patrick Thompson: I am very grateful for the opportunity to raise the subject of water metering in Norwich. I am pleased to welcome my hon. Friend the Minister, who is to reply to the debate. I was worried whether he would get to the Front Bench in time, but he is there and I welcome him and his colleagues.
This is an important subject, because East Anglia has the lowest average annual rainfall of any region in the United Kingdom, comparable to that of the southern coastline of the Mediterranean. I had the privilege of raising the implications for Norwich and Norfolk of that water scarcity in an Adjournment debate back in February 1992.
You may recall, Mr. Deputy Speaker, that at that time we had had a long period of drought and water depletion. I remember arguing strongly for the installation of water meters. That is the subject to which I am returning tonight. It was an important subject then, and it is more important now. The efficient use of water and water conservation measures matter more to us than to people in other parts of the country.
My concern is not specifically the provision of water meters to consumers in my constituency, but the decision of Norwich city council to deny the opportunity to its periodic or weekly tenants to have meters installed. The city council owns almost 20,000 homes in Norwich —more than one third of all homes in the area—so a large number of people are being denied the opportunity to cut their water bills. That is particularly true of elderly people, small families and individuals. When making its decision and ignoring the well-informed local campaign work of people such as Bashir Khanbai, John Fisher and Robert Kinghorn, the Labour majority on the council has shown itself to be out of date and seriously out of touch with the people of Norwich.
The ostensible reason for the policy appears to be that the installation of water meters would discriminate against those who may need to use large quantities of water—the disabled, those with long-term illnesses and people with large families. The council defends its position on the further ground that any advantage to existing tenants may prove a disadvantage to subsequent tenants of properties with water meters. It has been alleged that there are grave public health concerns over the issue. As a result, the city council has barred its tenants from taking advantage of the metering options offered by Anglian Water.
Other councils in Norfolk—such as South Norfolk district council and North Norfolk district council—with Broadland housing association and others, have no objections in principle to the installation of water meters in their properties. I understand that the Anglia housing association judges each application for the installation of water meters on its merits and supports the installation of meters in homes occupied by elderly tenants. The Wherry housing association in my constituency also agrees to the installation of meters when tenants request them. Single and elderly tenants welcome the opportunity to cut their bills by up to three quarters. Wherry housing association has had no complaints about water metering from its


tenants. The tenant profiles of the associations must be broadly similar to that of Norwich city council—they certainly operate in comparable areas. If metering is acceptable to them and to their tenants, it should also be acceptable to the city council.
The logic of the city council's position is dubious and its motives must be open to the gravest suspicion. I do not believe that the council is in a position to judge who among its tenants will benefit from the installation of water meters. That is a decision that the tenants themselves are best fitted to take. The present system of basing water charges on the former domestic rating system means that bills in Norwich are high because rateable values were high.
Elderly people and single occupants have higher bills than they would with water meters. For example, a single person pays an average water bill of £294 a year in Anglian Water's region. That could be cut to between £89 and £179 with a water meter. Couples with or without children could save between £75 and £150 per year. Many pensioners and others among the city council's tenants find themselves subsidising other water consumers, including other council tenants, because they are forced to pay for their water on the basis of rateable value. I hope that my hon. Friend will agree that that cannot be right.
Pensioners and people who are disabled, or who have large families, or are suffering from illness, are precisely the people who are most likely to be living on a limited income and who are most keen to be able to judge whether they would benefit from careful use of water. Anglian Water has estimated that 70 per cent. of its customers could save at least 10 per cent. on their water bills by using meters, which typically save up to 15 per cent. of water usage.
Boreholes are already being sunk under Norwich to guarantee future water supplies. Without further water conservation measures, there might have to be a new reservoir—costing about £300 million. Why should council tenants be prevented from cutting their bills and saving water? No council can tell that all future tenants will be disadvantaged by having the opportunity to occupy premises with water meters. Norwich city council assumes that all future tenants will come from large families and will not want water meters. There is no guarantee of either.
If tenants think that they may benefit from installing water meters, they should be able to choose to have them. The issue in this debate is choice. They should be able to choose to have meters installed without town hall obstruction. The rights of tenants, therefore, must come first and not last in Norwich city council's thinking.
The attitude of the council is particularly worrying since our local water supplier, Anglian Water plc, has shown itself to be acutely aware of its social responsibilities. It has created a wide range of schemes to help customers meet their water bills. Large, low-income families have been targeted for that aid. Customers can pay by cash, through any post office or high street bank, by direct debit through bank accounts, by instalments paid at post offices or banks, with water savings stamps, which can be purchased at most post offices, through the Girobank or through the post. People on income support can apply for payments to be made direct from their

benefits by the Department of Social Security. It is no accident that the Norfolk area has proved to be the second most enthusiastic of all those covered by Anglian Water for accepting water meters.
Moreover, Anglian Water recently announced that all domestic customers who pay for their water through the use of water meters will have their service pipes from the stop tap to the side of the house maintained free of charge as from 1 January 1997. At present, the owner of the property is responsible for the service pipe unless specific cover is in place. Norwich city council could save itself a good deal of money by encouraging its tenants to go on to water meters, thereby saving it the cost of repairing service pipes.
Anglian Water has also been conducting trials of special pre-payment methods, using smart cards in Milton Keynes and Wellingborough. The cards enable customers with large, accumulated debts to pay for their water and a small proportion of their arrears on a regular basis. I understand that they have proved extremely popular and that the potential exists for the extension of the technology to other parts of the East Anglia region.
I want to mention the creation of the water trust fund, which is administered by an independent board of trustees to help customers in serious arrears to make a fresh start. Anglian Water contributed £2 million to that fund earlier in the year, and the first grants have already been made, using the machinery of the citizens advice bureaux.
The Office of Water Services, the regulatory body for the water industry, believes that metering is the best and fairest long-term method of paying for water. Its view is that all customers should have the option of using water meters and that customers with high discretionary usage should certainly do so.
Ofwat has the support of its national consumer council for the position that council tenants should have the option of having water meters installed, giving them more control of their bills. The national consumer council believes that local authorities that deny their tenants that option are behaving unreasonably.
Despite what I said earlier about the case put by Norwich city council, no instance of a risk to health arising from the installation of water meters is known to Ofwat or to the water supply companies. It is clearly in the wider interest of efficient water usage that meters should be installed in new homes and in older ones where tenants desire them. That is one reason why Ofwat has opposed unduly high standing charges for domestic customers and has taken action to balance tariffs.
The cost of installing meters has been significantly reduced since 1994–95; 23 companies have reduced their charges, five have not changed them since 1994, and no company has increased its installation charges since 1995–96.
Does the 1991 water legislation require water companies to supply water meters if they are requested by tenants or occupants of residential property? If so, can Norwich city council be sued by its tenants for not allowing them to install meters? The Environment Act 1995 certainly places a duty on water companies to encourage the efficient use of water in their area of operation, a duty that Norwich city council has decided to prevent Anglian Water from fulfilling.
The sorry truth about water metering in Norwich is that the city council does not trust its tenants to make decisions in their own interests. They are not allowed to choose


between metering and the present system of payment, which is to the disadvantage of many groups, especially the elderly, because that would diminish the control that the council exercises over them.
To allow tenants to make savings on their water bills would compromise their dependent status. Properties with water meters might well prove more attractive than those without. Once the floodgates of metering had opened, the council might be compelled to widen choice for all its tenants. The record of old Labour and new in Norwich suggests that it may be time for the council's control over such a large proportion of the housing stock to be ended, and for modern social landlords, responsive to the needs of tenants, to take up the reins of management in the interests of the wider community.

The Parliamentary Under-Secretary of State for the Environment (Mr. James Clappison): I am grateful to my hon. Friend for raising this matter, and I am sure that many of his constituents will be grateful to him for so forcefully expressing his concerns.
As my hon. Friend rightly says, he has a background of concern about conservation and water issues, and I am sure that he speaks for many individuals in Norwich, especially the tenants of Norwich city council, when he so clearly expresses his worries about the denial of choice by the council and its failure to take into account the needs of environmental good husbandry. As he rightly said, it is regrettable that tenants are being denied choice and that the needs of the environment are being ignored by the council.
We accept that the good husbandry of water resources is an important part of sustainable development. It is also part of the challenge of global warming, not least for an already dry area such as East Anglia, as my hon. Friend so clearly stated. The development of new sources of water supply may be necessary, but our first recourse should be to make the best use of existing supplies. Last month, the Government published a comprehensive examination of the problem, "Water Resources and Supply: Agenda for Action", with a number of action points for the Government, the regulators, the water companies and consumers.
I shall mention a few of the steps that are being taken. The Government, through the Office of Water Services, are pressing water companies to reduce leakage in their distribution system to an economic minimum. The Director General of Water Services has published each water company's long-tern leakage target and the targets for the next financial year.
Reducing the use of water through demand management makes sense. Since 1 February, all water companies have had a new duty to promote the efficient use of water by their customers. Efficient use of water means using water-efficient equipment and cutting leakage in customers' pipes, as well as informing the public about the relationship between water use and supply. When all other measures that should be taken have been taken, the key to the efficient use of water must lie with the user. In that respect, my hon. Friend's concerns have great force.
Domestic demand has been growing over the years, with the widespread use of appliances such as automatic washing machines and the increased ownership of

dishwashers. The popularity of gardening and the use of garden sprinklers also has a marked impact in summer. In one hour, a sprinkler can use enough water to supply a family of four for two days. We are not trying to discourage clean cars or green gardens, but there is a strong case for saying that customers should pay for them.
My hon. Friend argued eloquently for the merits of water metering as a means of conserving water resources and postponing or eliminating the need for new boreholes or reservoirs with all their environmental implications. I agree with his remarks. The encouragement of metering is a key element in the Government's water strategy. There is widespread resentment, especially in times of water shortage, that neighbours can be using vastly different quantities of water without any effect on their bills. Metering is fair: one pays only for what one uses. It is also successful.
Trials have shown an immediate reduction both in water use and in many customers' bills. Customers are being denied that opportunity by Norwich city council and water use is being affected adversely. I must make it clear that the Government do not control or impose the method of charging for water. That decision is for the water companies. The proviso is that they should operate within the rules set by statute and supervised by the Director General of Water Services.
On the method of charging, the law simply requires that companies should not set prices that are unduly discriminatory or preferential. The decision is up to water companies but, of course, the Government have a view on the charging method, which we have spelt out. We believe that the gradual extension of metering, together with the development of more sophisticated tariff structures, has an essential role to play in managing demand for water. In general, we believe that the introduction of water metering should be selective and that switching to metered charging should be voluntary for occupiers who are charged in their present properties on the basis of rateable values. However, new properties should be fitted with meters as the norm, as should those with high external use for garden watering and swimming pools. Where an occupier moves to a dwelling with a meter, charging should be metered.
I welcome the fact that companies are reducing the cost of their voluntary meter option schemes and that eight companies, including Anglian Water, offer free installation for customers who want meters. That is the Government's policy on metering, although it is for companies to make the choice of charging methods. This is the background to what is happening in Norwich.
Anglian Water is pressing ahead with the installation of water meters. I understand that it has adopted a programme of installing meters in all properties. That is a long undertaking, with a target of 40 per cent. coverage by 2000. Where it fits meters, it gives existing customers the choice of continuing on the old rateable value basis or switching to a metered bill, whichever customers choose as the lower for them. For normal domestic uses, it is only with new or substantially altered properties or where new customers enter properties that already have meters that the company requires metered payment. In those cases, the customer should know beforehand what he is taking on as part of the dwelling. Anglian also requires metered payment when the customer uses a garden sprinkler or has a swimming pool. Anglian will install meters for


customers on request. That offers many customers a quick route to immediate savings, as my hon. Friend's calculations showed.
I understand that Norwich city council has adopted a policy of root and branch opposition to water metering. It is apparently not interested in the environmental arguments for saving water or in giving its tenants the choice of whether to be metered. It should be noted that for many of the least well-off, especially single-person households and pensioners, metering would offer savings on their current water bills with no change in their water consumption habits. Meters offer every household greater control over water bills. The sensible use of water can go a long way to trim bills.
My hon. Friend asked about the legal position on the installation of meters, and wanted to know whether tenants have any recourse if the city council obstructs the installation of meters even when they have been requested. When Anglian Water or any other water company is carrying out a programme of meter installation, the company gives notice to customers and then has powers, like other statutory undertakers, to enter premises and fit meters even over the objections of the council or any other landlord.
In the long term, Norwich city council or any other council cannot prevent the steady progress of meter installation. Where, however, the company is fitting at the voluntary request of the tenant, the situation is different. In meeting the customer's request for a meter, Anglian Water is not invoking any powers of compulsion.
There is a duty on local authority tenants under the Housing Act 1985 not to carry out an improvement without the consent of the landlord, which may not be unreasonably withheld. The law treats adding a water meter as an improvement. If the local authority landlord refuses consent, the tenant may not make an unauthorised improvement. Where the tenant has asked for the meter, it is like the tenant calling the builders in. It is up to the tenant to ensure that he has the necessary consent.
If the water company is asked by a tenant to install a meter, it will assume that the customer has any necessary consent. It will continue installing on request. If a tenant has a meter installed without the consent of the landlord, that is in law a matter between the landlord and the tenant, not the water company.
If a tenant is refused consent, his recourse would not be to sue the landlord. The law provides that such consent may not be unreasonably withheld. That would be the issue. In the end, it would be for the courts to decide whether the council had been reasonable in withholding its consent.
I hope that the issue will not come before the courts. I hope also that Norwich city council will listen to the force of my hon. Friend's arguments and reconsider its policy on water metering. I understand that, even now, the eastern customers service committee of Ofwat, which represents the customers of Anglian Water, has written to the city council to ask it to support water metering.
Whatever policy the council adopts, the legal position is that it cannot prevent the progressive installation of meters under Anglian Water's rolling programme. The council can delay only by depriving individual tenants of the choice of voluntarily moving at once to lower metered bills.
Metering is the fair and sustainable way to charge for water use. I hope, as I have said, that the debate will be heard by the council, and that it will listen to the reasonable arguments that have been advanced by my hon. Friend. I hope also that it will consider the interests of its tenants, including those who wish to exercise there choice in this matter, and grant them that choice. In doing so, it will act in the interests of consumer choice and in the wider interests of the environment. Those are two forceful arguments in favour of the council acceding to the reasonable arguments that have been advanced by my hon. Friend.

Question put and agreed to.

Adjourned accordingly at twenty-three minutes to Eleven o'clock.